October 4, 2018

Home Health Leaders Applaud the Introduction of the Home Health Payment Innovation Act

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WASHINGTON – The Partnership for Quality Home Healthcare commends Senators Susan Collins (R-ME), Bill Nelson (D-FL) and Debbie Stabenow (D-ME) for introducing the Home Health Payment Innovation Act (S. 3545) in the Senate to improve home health payment reform to ensure beneficiary access to quality care services is not compromised for America’s growing senior population.

S. 3545 is the third piece of legislation introduced to address the issues with the Centers for Medicare & Medicaid Services’ proposed Patient Driven Groupings Model (PDGM) to ensure behavioral-based payment changes are grounded in evidence and observed data. Recently, Senators John Kennedy (R-LA) and Bill Cassidy (R-LA) introduced S. 3458 in the Senate and Representatives Ralph Abraham (R-LA), Garrett Graves (R-LA), Scott DesJarlais (R-TN), Vern Buchanan (R-FL), and Terri Sewell (D-AL) introduced H.R. 6932 in the House.

These bills would require Medicare to implement adjustments to reimbursement rates only after behavioral changes by home health agencies (HHAs) that affect Medicare spending actually occur instead of assuming changes might happen. By requiring the payment model to utilize observed evidence of behavioral changes, the bills would ensure a smoother transition to the new payment system, which is the most significant payment change to the home health system in more than 20 years.

Additionally, S. 3545 includes a provision strongly supported by the home health community that would permit the waiving of the homebound regulatory requirement to enable greater flexibility for Medicare beneficiaries in Medicare Advantage plans (and waiver programs) to receive home health services.

“The Partnership applauds the bipartisan leadership of Senate and House lawmakers for introducing these critical pieces of legislation, which will better align Medicare payment with patient care by ensuring payment adjustments are made based on actual observed behavioral changes among providers,” said Keith Myers, Chairman of the Partnership. “With a growing number of seniors – especially seniors who are frail and suffer from multiple chronic conditions – requiring home healthcare, it is imperative that home healthcare services are not disrupted for this vulnerable population.”