On October 29, the Centers for Medicare & Medicaid Services (CMS) released its Home Health Prospective Payment System final rule for 2021. The final rule reflects comments the Association for Clinical Oncology (ASCO) submitted on the proposed rule in support of increased access to telemedicine in home healthcare and concerns over home infusion of chemotherapy.

In response to ASCO’s support for telemedicine in home healthcare, in 2021, CMS will allow home health agencies (HHAs) to utilize telecommunications technologies in providing care to beneficiaries under the Medicare home health program on a permanent basis, as long as the telecommunications technology is:

• Related to the skilled services provided
• Outlined in the plan of care
• Tied to a specific goal and indicates how such use would facilitate treatment outcomes

In the final rule, CMS thanked commenters for their support, and quoted ASCO’s comments when stating that “these changes would ensure patient access to the latest technology and give home health agencies the confidence that they can continue to use telecommunications technology” and “allowing services via telecommunications technology is especially useful for certain vulnerable subsets of Medicare patients, such as cancer patients who may be immunocompromised, by helping to reduce exposure to all illnesses, not just COVID-19.”

ASCO’s comments on the proposed rule also expressed concerns about the safety of home chemotherapy infusion and asked CMS to consult with oncologists prior to implementing its proposal in 2021. CMS did not acknowledge that request in the final rule, and the agency will move ahead with the home infusion benefit proposals in 2021 as discussed in the proposed rule.

The final rule updates the 2021 home infusion therapy services payment rates for three categories of home infusions (including chemotherapy) using the 2021 Medicare Physician Fee Schedule amounts, excludes home infusion therapy services from home health services as required by law, and implements Medicare enrollment policies for qualified home infusion therapy suppliers.

ASCO will continue to monitor the implementation of the Medicare home infusion benefit and encourage CMS to consider the American Society of Clinical Oncology’s position statement on home infusion of anticancer therapy.

Bookmark ASCO in Action for updates as the rule is implemented.