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House Lawmakers include HHGM in Proposed Spending Bill

A new proposed spending bill to keep the federal government running includes several home health provisions, particularly the reintroduction of a controversial overhaul to the Medicare payment system known as the home health groupings model (HHGM).

HHGM was first introduced in the proposed rule setting 2017 Medicare payment rates for home health, but after fierce industry backlash, was left out of the final version of the rule, released in November 2017 due to public outrage. However, there were indications that HHGM might be brought back by CMS. The draft spending bill puts HHGM back on the table for discussion, if the draft bill is passed.

The draft bill is a short-term budget plan from Congressional Republicans that would fund the federal government through March 23, 2018. Lawmakers must strike some sort of budget deal and pass legislation by February 9 to avoid another short-term government shutdown, like the one that occurred last month. Section 2201 of the bill calls for home health payment reform similar to HHGM, notably the transition to a 30-day unit of payment for home health services, to be effective starting in 2020. Currently, providers are reimbursed in 60-day units. Unlike the original HHGM proposal, this one calls for implementation to be budget-neutral. When the Centers for Medicare & Medicaid Services (CMS) first introduced the HHGM framework last year, it estimated that it would result in an overall $950 million payment cut for providers if implemented in a non-budget neutral manner and about a $480 million cut if implemented in a partially budget-neutral manner.