In its proposed rule for the Medicare Home Health Prospective Payment System (PPS) for calendar year (CY) 2023, the Centers for Medicare & Medicaid Services (CMS) proposed changes that would decrease payments by 4.2% compared to 2022 reimbursements. CMS proposed a 2.9% PPS increase, but the increase is tempered by a proposed -7.7% adjustment related to the home health Patient-Driven Groupings Model (PDGM) and 30-day unit of payment, and an estimated -0.2% adjustment that affects the fixed-dollar loss ratio used in determining outlier payments. As a result, Medicare home health spending is projected . . .