Senators Call on HHS to Scrap Some Medicare Home Health Changes

Congressional pushback is mounting against drastic Medicare payment changes for home health agencies.

A bipartisan group of 49 senators said in a Sept. 26 letter to the Department of Health and Human Services that it was responding to concerns that “the proposed rule lacks sufficient information and data points to allow home health agencies to accurately estimate the impact” of the proposed changes. The chairman of a Senate committee has also expressed concern about the proposal.

The lawmakers, led by Sens. Marco Rubio (R-Fla.) and Bill Nelson (D-Fla.), were responding to a July proposed rule (RIN:0938-AT01) for 2018 payment policies that has been criticized by home health providers. At issue is the proposed rule’s inclusion of a home health groupings model, under which Medicare would pay for up to 30-day episodes of care instead of the current 60-day unit. A provider group, the Partnership for Quality Home Healthcare, said the proposed model could put 3.5 million beneficiaries “at risk for care disruptions,” and would cut home health reimbursements by $950 million in 2019 alone.

The letter also asked the HHS whether the agency plans to provide data used to determine the cost estimates of the new model to home health providers.

“While we support efforts to increase efficiencies in Medicare, we believe this must be done in a prudent manner that does not compromise access to care for the increasing number of seniors who depend on these services to remain healthy and at home in their communities,” the senators said.

The changes would affect the more than 10,000 Medicare-participating home health agencies in the U.S. These companies include Kindred Healthcare Inc. and HealthSouth Corp. Comments on the proposal were due Sept. 25. A final rule is due by Nov. 1.

Hatch Letter

Seema Verma, administrator of the Centers for Medicare & Medicaid Services, said the new payment system would be more responsive to patients’ needs. “The new payment system aims to encourage innovation and collaboration and to incentivize home health providers to meet or exceed industry quality standards,” she said in a statement following the proposal’s publication.

In a Sept. 22 letter Sen. Orrin Hatch (R-Utah) said he supported aligning Medicare payments with patient care needs but thought the agency was moving to finalize complex policy changes too quickly.

“Additional time is needed not only to provide stakeholders the opportunity to analyze fully the proposed changes and provide substantive input to CMS through an open dialogue, but also to ensure that any payment reforms are implemented in the least disruptive manner possible,” Hatch said.

“More robust data analysis is needed to assure the agency’s proposed methodology and implementation strategy achieve our shared goal of improving home health payment accuracy, he said.” Hatch chairs the Finance Committee, which has authority over Medicare.

The CMS didn’t immediately respond to a request for comment.

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