Overall, the fiscal year 2023 omnibus bill released December 20 supports greater transparency in Medicare Home Health payment data and extends critical hospice face-to-face flexiblities. Below is a summary of the bill’s provisions of particular interest to home heatlh agencies and hospices as well as other aging services providers.
Home Health Agencies
CMS Release of Home Health PDGM Data. In the proposed Consolidated Appropriations Act, 2023, Congress instructs CMS to release data that LeadingAge requested in our rule comments. In years past, CMS had included data used to observe behavioral changes from the previous payment system to payment driven groupings model (PDGM). However, in the CY2023 proposed rule, this data was not available to providers. Having this data will allow for the comparison of behavior before and after the change to PDGM and enable providers to give CMS more accurate feedback on points of disagreement. What’s more, the legislation also requires CMS to meet with stakeholders to receive feedback on rate development for CY2024 and to also release the applicable data in advance of that public meeting. Even though this legislation will not impact the rates for CY2023, that Congress listened to our advocacy and took action to address our concerns is a positive – and LeadingAge is hopeful that this will put us on the path to achieving a payment approach that works for our mission-driven, nonprofit members and guarantees that all older adults and their families can get needed care and services. LeadingAge will monitor the release of this data and notify members on how to access the information and when opportunities for public input will be made available.
Extension of the Home Health Rural Add On. The home health rural add on was extended for episodes that occur in CY2023. Stakeholders will need to continue to advocate for the sustainability of this add on in the future but for now it is an exciting step toward continuing to support rural providers serving older adults.
Hospice Face to Face Recertification Extension. Throughout the Public Health Emergency (PHE) hospice providers were given the flexibility to utilize telehealth to conduct face-to-face recertification visits. Earlier this year, in the FY2022 omnibus spending package, this flexibility was extend along with a number of other telehealth flexibilities for 151 days starting the first day after the end of the PHE. The Consolidated Appropriations Act, 2023 further extends the ability for hospices to do the face-to-face recertification via telehealth was extended for two years until December 31, 2024. This was part of another broader package of telehealth flexiblity extension.
Bereavement and Grief Care Quality Standards. The agreement includes $1,000,000 to fund an evidence review and technical expert panel on the feasibility of developing consensus-based quality standards for high quality bereavement and grief care. Hospice is the only provider group specifically named that must be consulted in the process. This was a LeadingAge authored provision. LeadingAge also advocated for the inclusion of report language on the scope of the need for grief and bereavement services – this language was also included.
Addition of Marriage and Family Therapists and Mental Health Counselors to Hospice IDT. The bill allows for marriage and family therapists and mental health counselors to serve on the hospice IDT in the social work role (it does not require one of these professionals, it just allows them to fill this role). This was part of a broader package of mental health issues that Congress worked on for several months. Hopefully helping alleviate some of the recruitment issues we’ve been hearing from members.