CMS final rule expands ACO application cycle and removes barriers to home healthcare planning

In an interim final rule with comment period (IFC) issued April 30, CMS made financial adjustments to benefit Accountable Care Organizations (ACO) and granted greater flexibility to home health providers for the review and certification of patient care plans.

The final rule made changes to the Shared Savings Program to provide ACOs with greater financial stability and predictability during the COVID-19 pandemic. CMS is forgoing the ACO application cycle for 2021, giving ACOs whose participation is set to end this year the option to extend for another year. The agency is also allowing ACOs to maintain their current financial level of risk for next year instead of being automatically advanced to the next level of risk.

In the Coronavirus Aid, Relief, and Economic Security Act, CMS mandated that nurse practitioners, clinical nurse specialists, and physician assistants could provide home health services during the COVID-19 pandemic. The April 30 final rule grants greater flexibility to these professionals, allowing them to order home health services, establish and review care plans for home health patients, and certify that a patient is eligible for home health services. Previously, certification from a physician was required for beneficiaries to receive home health services. These changes are effective for both Medicare and Medicaid.

More information on IFC changes is available in a previous Revenue Cycle Advisor article here. 

CMS will be accepting comments on the IFC once it is published in the Federal Register. Facilities and providers should continue to provide feedback to the agency as the public health emergency evolves.