Home Health & Hospice Week

Industry Note:

Don't Look For PDGM Changes In 2020 Final Rule

You may find reasons, but not revisions.

A sweeping new home health payment system takes effect Jan. 1, but the payment and regulatory rule governing 2020 doesn’t make any changes to PDGM’s structure.

Why? Many commenters on the 2020 proposed rule took issue with parts of the Patient-Driven Groupings Model’s mechanics, ranging from giving increased payment for institutional admissions to eliminating therapy visits as a case mix factor to shedding separate payments for nonroutine supplies.

In the final rule, the Centers for Medicare & Medicaid Services supplies justification for many of the topics addressed, but doesn’t make any new changes to the model. That chapter closed with last year’s rulemaking cycle.

In other words: “PDGM is still coming,” says attorney Robert Markette Jr. with Hall Render in Indianapolis.

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