Hospice Impacted by Home Health Proposed Rule

CY 2024 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Program Requirements Have Been Posted

Summary at a Glance

Today, in the 4:15 p.m. ET posting of the Federal Register for June 30, 2023, the Calendar Year (CY) 2024 Home Health Prospective Payment System Rate Update and Quality Reporting Program Requirements proposed rule was posted to the public inspection part of the Federal Register. Hospice provisions were included in this CY 2024 Home Health rule because CMS had additional proposed regulatory text to include. This text was either developed since the Hospice Wage Index proposed rule was published, or some details were not ready at the time of the hospice rule publication. The Home Health rule is an alternative to allow additional proposed hospice provisions to be included in the same rulemaking year.

Key Sections of this proposed rule include:

Hospice Informal Dispute Resolution process, allowing a hospice with condition-level deficiencies seeking recertification to have an informal opportunity to resolve disputes related to survey findings.

Special Focus Program proposed implementation regulations, including an algorithm for admission to the special focus program (SFP), requirements while enrolled, process for graduating from the SFP and termination from the Medicare program.

Provider Enrollment proposed changes, including:

  • Highest level of screening for newly enrolling hospice providers
  • Fingerprinting requirements for all 5 percent or greater owners
  • Deactivation for 6 months of Medicare non-billing

Ownership Requirement:

  • The rule proposes to add hospice to the change in majority ownership now required for home health agencies.
  • Adds hospice to the HHA “36 month” rule – if the change in ownership occurs within 36 months after the effective date of the HHA’s or hospice’s initial enrollment in Medicare or within 36 months after the effective date of the HHA's or hospice’s most recent change in majority ownership, the provider agreement and Medicare billing privileges do not convey to the new owner.

NHPCO has begun the review of the proposed rule and will release a detailed analysis of the proposed rule and its components in the coming days. Any questions can be directed to [email protected] with ‘CY 2024 Home Health proposed rule’ in the subject line