CMS proposes reimbursing home health agencies for remote patient monitoring under Medicare

by dreid, on Jul 9

The Centers for Medicare and Medicaid Services (CMS) announced a proposed rule to allow home health agencies to be reimbursed for remote patient monitoring under Medicare. This means that home health agencies would be able to include remote patient monitoring in their cost reports. This year Medicare began reimbursing physicians for remote patient monitoring services however home health providers were excluded.

“Today’s proposals would give doctors more time to spend with their patients, allow home health agencies to leverage innovation and drive better results for patients.” — Seema Verma, CMS Administrator

What is remote patient monitoring?

Medicare defines remote patient monitoring as “under the Medicare home health benefit as the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the HHA.”

What are the proposed changes?

This proposal is part of the larger healthcare system moving away from fee for service and towards outcomes-based payments. Specific aspects of changes to the Patient-Driven Groupings Model and the Home Health Prospective Payment System are aimed at incentivizing a faster adoption of technology that provides real-time data to improve care.

  • CMS is proposing to define remote patient monitoring in regulation for the Medicare home health benefit and to include the cost of remote patient monitoring as an allowable cost on the HHA cost report form.
  • The proposed rule outlines Medicare payment updates and quality reporting changes for home health agencies for 2019.  
  • Case-mix methodology refinements to change payment from 60 days to 30 days is proposed to take place in 2020.
  • In terms of alerting, “The HHA must also promptly alert the relevant physician(s) to any changes in the patient’s condition or needs that suggest that outcomes are not being achieved, or that the plan of care must be altered (42 CFR 484.60(c))”

According to CMS, “Physicians who order home health services for their patients would also see administrative burden reduced under this rule. CMS is proposing to eliminate the requirement that the certifying physician estimate how much longer skilled services would be needed when recertifying the need for continuing home health care, as this information is already gathered on a patient’s plan of care.”

CMS is accepting feedback on the proposed rule until August 31, 2018. The proposed rule and the Request for Information can be downloaded from the Federal Register here.

For more information on how to integrate iUGO Care’s platform with your home health agency contact us today. 

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