CMS decides not to move forward with Home Health Groupings Model in 2019

The following is an excerpt from Home Health Line.
Agencies can breathe a deep sigh of relief. CMS won’t launch its drastically revised home health payment model after all.
In the 2018 final PPS rule released Nov. 1, CMS announced that it would not launch the Home Health Groupings Model (HHGM) in 2019.
“We are not finalizing the implementation of the HHGM in this final rule,” CMS said in the rule. “We received many comments from the public …

NAHC interim president: Odds of HHGM happening in 2019 are 50/50

The odds of the home health industry avoiding the Home Health Groupings Model in 2019 have worsened, an industry expert says.
Bill Dombi, interim president of the National Association for Home Care & Hospice (NAHC), told attendees at NAHC’s annual conference that there’s now only a 50/50 chance that the HHGM will be postponed or withdrawn.

CMS shifts from denials to RTPs for home health claims with no matching OASIS

The following story is from Home Health Line.
Home health agencies will now have their claims returned when Medicare systems fail to match those claims with a corresponding OASIS assessment.
Based on new requirements that went into effect in April, agencies started receiving denials when a claim was submitted, but a matching OASIS could not be found.
On Oct. 12 CMS announced this situation will no longer result in an automatic denial, but instead CMS will Return …

2018 hospice final rule increases payments by $180 million

by: Josh Poltilove

The following is from Home Health Line. For more news and information on home health and hospice, visit

Medicare’s hospice payments, adjusted for inflation and other factors, will rise an estimated 1% in 2018, according to the final hospice payment rule posted Aug. 1.

 That’s a $180 million increase.

 By comparison, the 2017 final rule included a 2.1% increase — $350 million — in payments.

The dropoff is largely due to a one-time reduction in the …