Partnership for Quality Home Healthcare Applauds Lawmakers for Exploring Ways to Improve the Medicare Program

WASHINGTON – 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 – today joined other home healthcare advocates in thanking the House Energy & Commerce Subcommittee on Health for hosting a Congressional hearing to examine potential ways to improve the Medicare program, including legislation that would streamline current “face-to-face” documentation requirements in order to secure patient access to clinically advanced, cost effective, and patient preferred Medicare home healthcare services.

Under current Medicare policy, home health agencies are forced to contend with inconsistently administered Medicare documentation rules in order to meet Centers for Medicare & Medicaid Services’ (CMS) requirements and receive appropriate reimbursement for physician-prescribed home healthcare services. Too often, this overly complicated process leads to delays in patient care and denial of coverage for skilled home healthcare.

Legislative reform now under consideration would resolve these problems by updating face-to-face (F2F) documentation rules, reducing the paperwork burden on physicians and home health agencies, and minimizing the risk of inappropriate denials of care. The legislation achieves these important outcomes by directing CMS to utilize a standardized form, developed in consultation with stakeholders, to document beneficiaries’ eligibility for home health services. Importantly, this reform will also eliminate the burden on physicians by enabling home health agencies to prepare the documentation for their review and by eliminating duplicative documentation for beneficiaries who have been discharged from a hospital or skilled nursing facility within 14 days prior to the initiation of home healthcare. This common-sense reform would also establish a process for review of inappropriately denied claims, ensure educational outreach to key players, and provide for a study and report to Congress on the effectiveness of this streamlined process.

“We proudly support the efforts of Representative Walden and the U.S. Congress to reform overly burdensome documentation requirements that are putting patient access at risk,” said Eric Berger, CEO of the Partnership for Quality Home Healthcare. “This legislation will significantly improve a flawed process that is unworkable, administratively burdensome, and resulting in coverage delays and denials.”

Current policy is endangering access to care for the most vulnerable patient population in the Medicare program. Indeed, Medicare’s home health beneficiaries are documented as older, sicker, poorer and are more likely to be female, a minority, and disabled than all other beneficiaries in the Medicare program combined.

The Partnership previously expressed support for the Home Health Documentation and Program Improvement Act of 2015 (S. 1650) – introduced by Senators Robert Menendez (D-N.J.) and Pat Roberts (R-Kan.) – which would similarly help to ensure that homebound Medicare beneficiaries have access to clinically-necessary home healthcare services.

Today, nearly 3.5 million homebound Medicare beneficiaries receive skilled home healthcare to treat illnesses related to acute, chronic or rehabilitative needs.