March 17, 2020

Home Health Sector Urges Flexible Use of Home Health Clinical Expertise and Regulatory Relief to Address COVID-19 Crisis

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WASHINGTON – Today the Partnership for Quality Home Healthcare, a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation’s seniors, released a list of strategic policy and regulatory relief suggestions that will improve access to home health, ensure patient safety, and streamline and eliminate any barriers to fully engaging the nation’s home health provider community during the ongoing COVID-19 emergency.

As an industry of highly skilled professionals caring for vulnerable populations with multiple chronic conditions, home healthcare agencies are uniquely qualified for treating individuals diagnosed with COVID-19. With more Americans (particularly the elderly and those with compromised immune systems) becoming vulnerable to contracting the novel coronavirus, home health represents a safe and available care setting for at-risk populations. As an alternative to facility-based care, home health is critical for ensuring the health of individuals who have, are suspected of having, or are at risk of developing COVID-19. Home health nurses can be deployed easily and quickly with telephonic visits to monitor COVID-19 patients who have, or do not have, symptoms of the virus. This frees up hospital beds and physician visits to care for ill and distressed patients who are sick and need monitoring, but not a hospital bed.

In response to the nation’s plans to address COVID-19, home health leaders released guidance regarding needed waivers and regulatory relief to ensure home health’s nimble and flexible response. Recognizing that home health professionals can play a major role in addressing the current crisis, the Partnership has been working with the Administration and Congress to identify avenues for expanding home health under current federal regulations and suggesting mechanisms to address these issues.

The Partnership is asking for regulatory relief and clarification in the following areas:

  1. Enable home health professionals can more easily reach patients using telephonic and telehealth visits: Home health nurses and clinicians need to be deployed using technology like telephones, and other telehealth devices, to monitor existing patients who want to limit anyone (even their clinician) from visiting their home and for COVID-19 patients needing health care monitoring by trained clinicians. The Centers for Medicare & Medicaid Services (CMS) should immediately allow for telephone visits to patients by Medicare certified home health providers. This will go far in containing the virus, in assisting patients in quarantine, in monitoring existing Medicare home health patients to ensure they will continue to stay in their homes and not seek hospital or physician care. In addition, the telehealth rules should be modified to allow home health clinicians to bill directly for services provided.
  2. Securing regulatory relief: Current regulation requires home health patients to first secure homebound status, yet it is unclear whether patients who have been diagnosed with or are suspected of having COVID-19 would be considered homebound under Medicare rules. Furthermore, Medicare requires face to face visits between doctors and patients prior to receiving home health. Waiving these requirements would result in more timely access to home health.
  3. Ensuring home health is prioritized and providers are able to access personal protective equipment (PPE) as it becomes available: PPE supplies are running low but are critical to preventing exposure during home health visits of COVID positive or quarantined patients that could harm home health workers or spread the virus to other homebound patients. Home health agencies are looking to CMS and the Centers for Disease Control and Prevention (CDC) for guidance on how to get the most out of PPE and encourage federal agencies to consider supply chain interventions in order to ensure continued access to PPE. Moreover, CMS should consider the higher costs of PPE in identifying appropriate rates for home health services during the coronavirus emergency and response.

The Partnership recommendations to CMS mirror recommendations supported by other home health sector groups, including the National Association for Home Care & Hospice.

“The home health sector asks CMS to make these regulatory and home health flexibility changes quickly through updated guidance to home health providers. Doing so will help unlock the full potential of home health and ensure that patients who can be treated outside of institutional settings are able to receive safe, quality home health services throughout the duration of the COVID-19 emergency,” said Joanne Cunningham, Executive Director of the Partnership.