Checking off a requirement mandated through the omnibus spending bill in December, CMS will be hosting a forum to dive deep into the methodology around PDGM and behavioral adjustments.
The industry had sought a freeze on proposed payment cuts in the spending bill, but had to settle for a public explanation of how CMS settled on the data justifying the cuts.
Congress required CMS to:
- Release the data and methodology used to predict behavioral adjustments at the center of payment cuts. They’re also expected to reveal data on actual behavior changes that have occurred since PDGM was implemented.
- Host an open-door forum or similar event to receive input from home health stakeholders and interested parties on the development of the home health payment rate.
CMS announced February 9 that it will host a webinar on March 29 from 1:30 to 3 p.m.
“Experts will provide an overview of several provisions from the 2023 Home Health PPS final rule related to behavior changes, the construction of the 60-day episodes and payment rate development for 2023,” according to the notice.
CMS shaved off more than 3.9% of home health payments with the 2023 final rule, and telegraphed that an additional 3.9% will be cut in the next year. It’s also looking at how to claw back $2.1 billion in reported overpayments in 2020 and 2021 and potentially another $1 billion in reported overpayments for 2022.