PDGM Articles and News

North Haven, Connecticut—To help home health and hospice organizations meet compliance standards and comply with the Center for Medicare and Medicaid Services’ Patient-Driven Groupings Model (PDGM) and Home Health Value-Based Purchasing (HHVBP), Corcoran Consulting Group (CCG) has partnered with Cliniqon, a tech-enabled company that specializes in home health and hospice coding and quality assurance, following all protocols and regulatory standards set by the Centers for Medicare and Medicaid

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has proposed a more than 4% cut to home health payments next year, a move that advocates say will continue to harm patients and providers. 

WASHINGTON—The Centers for Medicare & Medicaid’s (CMS) proposed rate reductions for home health could be devastating for agencies if they are codified, said Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). Even worse, CMS has left a door open to demand some $3 billion in clawbacks for prior years of what it interprets as over-payments.  

LAS VEGAS (July 26, 2022)—Two senators have co-sponsored legislation that would prevent proposed Medicare rate cuts for home health agencies, and a companion in the House is expected to follow later this week, the National Association for Homecare and Hospice (NAHC) announced.

ST. LOUIS (April 6, 2022)—The National Association for Home Care & Hospice (NAHC) is now accepting proposals to present new education at the 2020 Home Care and Hospice Conference & Expo in America's Center Convention Complex, St. Louis, Missouri, Oct.23-25, 2022.

The deadline for submissions is April 18, 2022.

WASHINGTON, D.C. (September 24, 2021)—The Medicare Payment Advisory Commission (MedPAC) met to discuss the development of a mandated report assessing the impact of the shift to the Patient Driven Groupings Model (PDGM) payment model for Medicare home health, and in particular the 30-day episode and the removal of therapy utilization in payment determinations.

WASHINGTON, D.C. (August 31, 2021)—The National Association for Home Care & Hospice submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the latest home health proposed rule 86 Fed. Reg. 35874. The rule proposed changes to the Patient Driven Groupings Model (PDGM) case mix and reimbursement based on 2020 care data.

WASHINGTON, D.C. (March 23, 2021)—The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 12085—Correction to Period Sequence Edits on Home Health Claims.

WASHINGTON, D.C. (November 6, 2020)—The Centers for Medicare & Medicaid Services (CMS) has issued another revision to change request 11855—Penalty for Delayed Request for Anticipated Payment (RAP) Submission—Implementation. The Change Request (CR) revision added remittance advice message information related to the No Pay RAP penalty.

Home health agencies (HHAs) should note that Medicare Administrative Contractors (MACs) will: 

WASHINGTON, D.C.

WASHINGTON, D.C.

WASHINGTON, D.C. (August 28, 2020)—The Partnership for Quality Home Healthcare—a coalition of home health leaders dedicated to developing innovative reforms to improve the program integrity, quality, and efficiency of home healthcare for our nation's seniors—submitted comments this week to the Centers for Medicare & Medicaid Services (CMS) in response to the CY 2021 Home Health Prospective Payment System (HH PPS) Proposed Rule.

NAHC to CMS: Roll Back 2020 Rate Adjustment Based on Faulty Prediction of HHA Behavior

DALLAS (August 12, 2020)—Homecare Homebase (HCHB) announced an expanded HCHB Analytics tool to help customers quickly and accurately identify the impact of proposed 2021 CMS Medicare reimbursement changes issued July 25th.