Bipartisan Bill Would Root Behavioral Payment Adjustment in Evidence

Home care organizations were pleased with a bipartisan Senate bill introduced Monday (Feb. 11) that would keep CMS from implementing any behavioral adjustment as part of a new home health pay system until the agency sees how providers react. Lawmakers introduced a second bipartisan bill on Monday, also on the home health providers’ agenda, that would allow physician assistants, nurse practitioners, clinical nurse specialists and certified nurse midwives to order home health services as opposed to just physicians.

The Home Health Payment Innovation Act was introduced by Sen. Susan Collins (R-ME), along with Sens. Debbie Stabenow (D-MI), John Kennedy (R-LA), Doug Jones (D-AL), Bill Cassidy (R-LA), Rand Paul (R-KY) and Jeanne Shaheen (D-NH). The bill modifies part of the Patient-Driven Groupings Model (PDGM) that was finalized by CMS last year.

Changing the behavioral adjustment was at the top of home health providers’ priority list, and the National Association for Home Care and Hospice said it planned to ask for Congress’ help as soon as CMS finalized the revamped pay system for home health in the 2019 pay rule. The new system, required by the Bipartisan Budget Act of 2018, is set to be put in place in 2020.

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