On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update the Medicare Home Health Prospective Payment System (HH PPS) and introduced a new case-mix adjustment methodology. The new methodology focuses on the beneficiary’s condition and resulting care needs, rather than the amount of care provided. The new case mix adjustment methodology was one of the provisions of the Bipartisan Budget Act of 2018. The proposed new case-mix system is called the Patient-Driven Groupings Model (PDGM). CMS intends to implement the PDGM on January 1, 2020. The PGDM eliminates . . .
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