APTA Advocacy Network Legislative Action Alert

After holding off on any big changes to home health payment in 2022, CMS plans to take some major steps in 2023 to address what it describes as the gaps between "assumed behavior changes and actual behavior changes" resulting from the Patient-Driven Groupings Model payment system implemented in 2020. Translation: The PDGM has cost significantly more than CMS hoped, so to reach its goal of budget neutrality compared with the previous system, the agency has proposed changes that would reduce payment by 4.2%, or about $810 million compared with 2022 amounts. 

The bulk of the cuts is directed at the 30-day payment rate, but even if those reductions are put into place in 2023, CMS believes more changes will need to be made in the future to recoup the payment differences that have already occurred under the PDGM — an estimated $2 billion gap so far. To that end, the proposed rule also seeks public comment on how to best make up the difference.

We need you to submit a comment to CMS on this issue. APTA is preparing comments on the rule to submit by the Aug. 16, 2022, deadline but we need your voice and your stories sent to CMS as well. Please use this template to send your comment and be sure to customize it with a personal story. Adding a personal story is important because it ensures it will be individually reviewed by CMS.

The deadline to submit comments is August 16, so we need you to act now and encourage others to send a comment of their own.

Thank you for your advocacy and making a difference on behalf of the physical therapy profession and the patients we serve.