Home Health Payment Innovation Act of 2019 (H.R. 2573/S. 433)

This legislation addresses concerns with the Patient Driven Groupings Model (PDGM) that took effect January 1. The legislation would require CMS to use actual changes in provider behavior based on claims and other data after PDGM is implemented (instead of assumed behavior) as the basis for payment changes to home health providers. The bills also limit an agency’s losses or gains to 2% per year.

With PDGM underway, Netsmart will be engaged with Partnership for Quality Home Health Care and the National Association for Home Care and Hospice (NAHC) in the process of the legislation being redrafted with a transparency focus.