HCAFeNews Has Moved!

December 15, 2015


We have moved HCAFeNews onto our HCAF website members-only section.

Click here to re-direct to the new HCAFeNews.

HCAF membership comes with meaningful benefits, including access to all of the latest home health updates happening in the Sunshine State! As an HCAF member, not only will you have exclusive access to HCAFeNews, but you will receive all of the latest updates directly in your inbox in eHighlights and Quality Corner, HCAF’s weekly and monthly e-newsletters. Click here to learn more about becoming a valued HCAF member today.


Representative Ray Rodrigues Awarded Home Care Legislator of the Year

July 31, 2015

ORLANDO, FL-  On July 29, Representative Ray Rodrigues (R-76) was awarded Legislator of the Year by The Home Care Association of Florida (HCAF). Each year, HCAF honors a lawmaker who has exhibited energy, dedication and steadfast leadership on behalf of Florida home care providers and patients. HCAF awards those who have proven commitment to the home care industry and the citizens of Florida to support their rights to receive safe and effective care at home. The award was presented at HCAF’s Annual Conference on July 29th in Orlando, where over 700 Florida home health industry leaders were in attendance. 

HCAF Director of Communications & Government Affairs, Leanne Norr, made the following statement:

“It’s time our lawmakers come up with viable solutions to deal with the rising senior population here in Florida and their health care needs. Representative Rodrigues not only understands the challenges that Florida home care patients face, but he has proactively supported 21st century solutions to enhance quality and access to care, like telemedicine practices.

“Representative Rodrigues’ staunch commitment to decreasing burdensome government regulations within the home health industry has allowed agencies to provide quality health care for more patients in the comfort of their own homes. Through his sponsorship and passage of HB 441 this past legislative session, he has saved home care agencies thousands of dollars, allowing them to keep their doors open for patients during a time where they face more stifling government regulations than ever before.

“We applaud Representative Rodrigues for his unwavering commitment to home health care and for his dedicated leadership helping home health agencies deliver quality care to more Floridians.”

Florida State Representative Ray Rodrigues made the following statement:

“The home care industry has proved that it can provide cost-effective, high quality health care to Florida residents. Home health professionals who dedicate their lives to helping patients receive quality care should be able to do their jobs without the continued threat of excessive government regulations.

“It’s our moral obligation to make sure that Florida patients get high quality care at affordable rates. Implementing policies that allow home health agencies to expand, hire more healthcare professionals, and care for more patients not only helps more people stay healthy, but it also contributes to a healthy Florida economy.

“I thank the Home Care Association of Florida for this honor and will continue to work on common-sense solutions that will help home care agencies and patients thrive.”


Background on HB 441

Senate Bill 1374 was passed in 2008 and implemented a Home Health Quarterly Report requiring all licensed home care agencies in Florida to submit a report each quarter to the Agency for Healthcare Administration (AHCA). No other type of health care provider was required to submit a quarterly report. 2,200 Florida licensed home care agencies faced overwhelming fines. If an agency failed to submit the quarterly report on the 15th day following each calendar quarter, the Agency for AHCA imposed an excessive $200 fine per day after that. It’s clear that these fees are excessive. As of January 2015, AHCA collected more than $5.6 million in quarterly report fines, most of that from honest providers who simply failed to meet the deadline. Two out of three agencies that have been fined are considered small businesses. These are not small costs to Florida home health agency owners trying to stay afloat.

In the 2015 legislative session, Representative Rodrigues sponsored and successfully passed HB 441, the home care industry’s top legislative priority during the 2015 legislative session. HB 441 eliminated the quarterly reporting requirement for home health agencies so that Florida providers could care for more patients in the comfort of their own homes without overreached government fines.

All There Is To Know About the CMS HH PPS Rule, VBP Pilot in Florida

July 24, 2015

HHPPS Rule 2016

CMS issued a proposed rule on July 6, 2015 that includes the annual payment rate update along with the Value-Based Purchasing (VBP) pilot program. Florida was selected as the only large state in the VBP pilot program leaving out California and Texas. Many suspect that was not a coincident and that the “random” selection that CMS touted was not truly random. Although HCAF has long supported the shift towards improving and rewarding quality care, this new proposed rule has many elements that are cause for concern. It is yet again another overreach by CMS that could be highly punitive to all HHAs in Florida who will be dealing with this on top of the CMS proposed cuts in reimbursement for 2016. It is imperative that Florida providers start preparing now for this significant change and HCAF is here to help you get started. Every minute of every day counts at this point.

We have created a hub on our HCAF website for our members to understand the rule, take action against it, and also prepare for the impending VBP pilot, which will begin in 6 short months. Please visit our page regularly, as we will continue to analyze the rule and post more resources for you to read.


Key Points for Florida HHA’s in 2016 Proposed Rule:

  • CMS officially designated Florida as one of the states in the VBP pilot. This means that in 2016, all certified HHAs in Florida will be forced to participate in and be impacted by a new payment model, aimed at improving and rewarding quality care. Agencies in Florida will have payments adjusted depending on the degree of quality performance achieved. Payments would change by 5% in each of the first two payment adjustment years, 6% in the third year and 8% in the final two years, CMS says. The value-based purchasing proposed program would be implemented Jan. 1, 2016 and end Dec. 31, 2022. The first year of adjusted payments would occur in 2018 but will be tied back to your performance results in 2016.
  • The basic PPS rule held no real surprises but continues to put forth more painful cuts. It simply carries out the third year of a four year phase-in of the rate rebasing plan. Congress required that the rate rebasing be done with equal installments over 2014 through 2017. CMS is capped at reducing the base episode rate by no more than $80.95 which is equal to 3.5% each year. So we are facing another 3.5% cut that will be slightly offset by the Market Basket increase. In the end CMS estimates that the net result of all of its rate proposals is a 1.8% reduction in Medicare payments to home health agencies or $350 million in 2016.
  • What was a surprise was CMS’s proposal to reduce rates for perceived “coding creep”. CMS alleges that HHAs have up-coded claims to levels that do not reflect actual changes in patients’ clinical condition. Coding creep adjustments have been imposed in the past. In the 2015 rate rule, CMS estimated the coding creep at 2.32%. With an additional data year, the level has risen to 3.44%. CMS proposes to phase-in the creep adjustment at 1.72% in each of 2016 and 2017 to penalize agencies for what they call “case mix creep.”
  • While, the proposal rule does not reference the 2% sequestration cut specifically, it is definitely expected that will continue in 2016 along with all the cuts mentioned above.


April 21, 2015

April 21, 2015
For Immediate Release
Contact: Leanne Norr
(850) 222-8967


HCAF Urges Governor, Legislature to Act Swiftly

On April 2nd, The Florida Senate passed the Florida Health Insurance Affordability Exchange Program that would accept federal funds under the Affordable Care Act to establish a state-run private insurance exchange for low-income residents. The Home Care Association of Florida, representing more than 2,000 licensed home health agencies that serve more than 150,000 Floridians on any given day, strongly supports the proposed plan to expand Medicaid in Florida.

HCAF President, Anthony Clarizio, made the following statement:


“Expanding Medicaid to 800,000 state residents who have jobs but cannot afford health coverage is not only a moral imperative, but is the only viable option to address basic health care for those who need it most.


“The home care industry, which provides care for 150,000 Floridians per day, plays an integral role in giving expanded quality care to an ever-growing population, all while saving the state money. Caring for patients at home is not only more cost-effective than institutional care, but also decreases hospital readmission rates. Expanding Medicaid would mean that home care providers could service more patients, saving both the government and patients millions of dollars.  

“Florida’s home care agencies are prepared to provide cost-effective, high-quality care to this expanded Medicaid population. The Home Care Association urges lawmakers to put partisan politics aside and provide the support our patients so desperately need.”   

Home Care providers across the Sunshine State also speak out in support of Medicaid expansion:

“Our company performs large percentage of personal care visits in the home for Medicaid patients in the statewide Long Term Care program. The insurance companies involved have reduced prices but assured the quality remains the same. With that reality, Medicaid in Florida has earned the right to grow. Through our company we have seen how expanding Medicaid will save money over all, and we support it.”

-Sean Schwinghammer, Director of Legislative Affairs & Business Development, Caring Home Care

“Medicaid expansion for the State of Florida will increase access to quality care for thousands of under-served Floridians. It is in the best interest of our state to consider Medicaid expansion as a viable option to allow for improving our overall community health and wellness and allow Medicaid patients to receive care support services in the comfort of their own homes.”

               -Bobbie D’Angola, Executive Management, United HomeCare

“Expanding Medicaid in Florida would not only mean that my agency could expand and thrive, but it would also mean that the overall quality of care for patients would increase. In an industry already stifled by government red tape and costly regulations, expanding Medicaid would be a step towards providing the relief our home care agency so desperately needs. There are not enough providers in the state to meet the needs of this under-served population and by expanding Medicaid the patients would receive the care they need. Patients deserve to be at the center of health care in Florida. Expanding Medicaid would significantly increase access to more patients right in the comfort of their own homes.”

-Denise Bellville, RN, SVP of Operations, Comprehensive Home Care

Background on Home Health and Medicaid:

  • AARP reports that on average, the Medicaid program can provide home and community-based long term care services(HCBS) to three people for the cost of serving one person in a nursing home.
  • AARP reports that states that invest in HCBS, over time, slow their rate of Medicaid spending growth, compared to states that remain reliant on nursing homes.

Click here for HCAF’s 2015 Legislative Priorities, including telehealth expansion and expanding prescription practices for ARNPs.

About HCAF

The Home Care Association of Florida is the #1 resource & advocate for Florida’s home care industry & patients, representing more than 2,000 licensed home health agencies that serve more than 150,000 Floridians on any given day right in the comfort of their homes. HCAF was founded in January 1989 & is a non-profit trade association that offers representation, communication & advocacy for providers, and gives them the information they need to deliver the highest quality & most cost-effective services to patients throughout the Sunshine State.

About Home Care

Home care encompasses a wide range of health and social services delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living. Generally, home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends.

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CMS to Host Second ODF Call on Proposed Home Health 5-Star Rating System

January 30, 2015

Special Open Door Forum is scheduled for Thursday, February 5, 2015 at 1:30pm – 3:00pm Eastern Time

Next week, CMS will be hosting an Open Door Forum call on their proposed 5 Star ranking system for home health providers. HCAF reported on this program in last week’s edition of eHighlights regarding concerns HCAF and other association and providers have about the proposed program.

HCAF strongly recommends providers join this call and learn more about this proposed rating system. It is certain that CMS must make changes in order for consumers to be able to accurately determine the true quality of an agency using these ratings. See below for information on the FREE call and make sure to join on February 5th!

The Centers for Medicare & Medicaid Service will host a second Special Open Door Forum (SODF) call to allow consumers, home health agencies (HHAs), and other interested parties to give additional input and feedback on the planned addition of star ratings to Medicare.gov’s Home Health Compare (HHC) web site.

The call follows up on their previous call on this topic and will include:

·       a summary of the comments received on the material presented at the earlier call and on other aspects of the methodology,

·       a presentation of their revised methodology, and

·       plans for next steps.

After the SODF presentation, the phones will be opened for comments and questions. A link to the materials for this SODF, including a slide deck, a summary of the revised proposed HHC star rating methodology, and an updated “Frequently Asked Questions” (FAQ) document will be available soon on the Home Health Quality Initiative Spotlight page here.

Comments about the star ratings system can be submitted by email after the call to the following address: HHC_Star_Ratings_Helpdesk@cms.hhs.gov

Special Open Door Forum Participation Instructions:

Participant Dial-In Number: 1-800-837-1935

Conference ID #: 73412220.

After the call, transcript and audio recording of this SODF will be posted to the Special Open Door Forum website here.

HCAF is offering training on 2015 Medicare Home Health PPS Billing in Tampa and Ft. Lauderdale!

January 28, 2015


HCAF is offering training for home care billers and collectors next month in Tampa and Ft. Lauderdale. There have been many changes that were made in the 2015 HH PPS Final Rule that will affect how your agency gets paid for your services. Making sure your agency’s billers and collectors are educated on these changes, including the new Face-to-Face documentation requirements is paramount in making sure you do not become the victim of ADRs and RAC audits. Read below for more information and then click to register today!


2015 Medicare Home Health PPS Billing
Tampa – February 10, 2015 from 8:30am – 4:30pm ET
Ft. Lauderdale – February 11, 2015 from 8:30am – 4:30pm ET

The Home Health PPS Regulation for implementation January 2015 has brought about changes to the PPS System, but most importantly the threat of more cuts in reimbursement. Knowledgeable billers and collectors are extremely important to agencies thriving in the current system, so do not miss this needed education! Be the first to be current on all Medicare billing regulations implemented in 2015. This workshop will lay a concrete foundation for home health billing, as well as, financial staff by giving billers a more effective approach to the Medicare PPS regulation, conducting Medicare verifications and understanding adjustments. We will discuss Medicare verifications on patients with HIQH screen examples & review adjacent episode calculations – field by field on claim forms. We will review the process of auditing a pre-bill for final claim purposes, both Medicare and Non-Medicare Payers, and review the details of billing for Non-Routine Supplies using billing guidelines. More and more scrutiny of agency records has been taking place in the form of ADR and RAC reviews. This session will identify the current risks and outline steps to manage that risk. If you are part of the revenue cycle in your agency this session is a must.

6.0 Continuing Education Credits for SN, OT, ST and ACCT:

Course Objectives: 

After this workshop, participants will be able to:
1. Calculate and evaluate the HHRG, HIPPS Code and Episode Exceptions.
2. Verify Medicare Eligibility of patients and calculate Adjacent Episodes.
3. Complete a RAP and Final Claim form.
4. Describe the process for effectively auditing a Chart for purposes of identifying pre-bill issues and Medicare Secondary Payor Issues.
5. Establish processes to improve revenue cycle management.


Melinda Gaboury is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS) which provides financial, reimbursement, clinical and cost reporting services to the home health, hospice and rehabilitation therapy industries. Melinda’s priority remains bridging the gap between clinical and financial issues in home health agencies.

Registration Fee
HCAF or other State Home Care Association Members: $149
Prospective Members: $249

Click here for the printable flyer


Judge Strikes Down New Companionship Services/Overtime Rule in Huge Win for Home Care Patients and Providers

January 14, 2015

Today, the U.S. District Court for the District of Columbia struck down the new Companionship Services/Overtime rule in a triumphant win for patients, staff, and providers of home health care. This ruling completely invalidates the rule, allowing for the current practices of payment for workers to remain in place indefinitely. This lawsuit which was strongly supported by HCAF and lead by the National Association of Home Care and Hospice was crucial to making sure patients would continue to be able to afford high-quality home care, as well as necessary for state budgets to be able to continue providing Medicaid home health. Your membership in associations like HCAF and NAHC is what allows us to advocate on your behalf on critical issues like this one, therefore we thank our members for their continued support and encourage all others to join today.

Please read the press release from NAHC below for details on the case. It is unclear if the Department of Labor will file an appeal on this ruling, but for now, we are celebrating this fantastic success!

NAHC, along with Home Care Patients and Caregivers, Wins Huge Victory: Federal Court Rules to Strike Down Controversial New Overtime Rule

The National Association for Home Care & Hospice (NAHC) and its members today celebrated the decision of the U.S. District Court for the District of Columbia invalidating a proposed new U. S. Department of Labor (DOL) overtime rule slated to take effect on January 1, 2015.

“This decision is a huge victory for patients and their families who will be able to continue receiving home care services without interruption. The decision is a huge victory for caregivers who will continue to be protected instead of being forced to work only part time. The decision is likewise a huge victory for the agencies that serve patients and employ caregivers, and who will see continuity in a rule that has been in effect for 40 plus years and had recently been sustained by the U.S. Supreme Court. Finally, the decision is a huge victory for the states and the federal Medicaid program.” said Denise Schrader, chairman of the NAHC Board.

This is the third victory in this lawsuit for home care interests within the last month. On December 22, the court ruled that patients are entitled to equal rights regardless of whether they or their families paid their home care bills or they were paid by the joint, federal-state health insurance program, known as Medicaid. On December 31, the court ruled for NAHC by agreeing to issue a Temporary Restraining Order (TRO) blocking the DOL from enforcing new rules related to “companionship” and “live-in” care. On January 9, the court, in considering a motion from NAHC attorneys for an injunction to block enforcement of residual parts of these rules through this date or a trial, stated that so much evidence was in the record there would be no need for a trial. The judge therefore agreed to give his decision on the case on or by January 14, when the TRO was set to expire. Today, the judge ruled for NAHC and home care interests, saying the proposed new DOL rules violated the law.

The DOL has not announced whether it will appeal this decision to U.S. Court of Appeals. NAHC President Val J. Halamandaris, stated “The home care community is prepared to defend this case before the higher court. We fought this case once before and took it all the way to the U.S. Supreme Court where we won by a unanimous vote of 8-0. We are prepared to do this again if we need to do so.”

“The victory in the case proves the power of unity,” said Halamandaris. “United, fighting on behalf of the aged, infirm, disabled, and dying, we cannot lose; divided we cannot win.” He also thanked Bill Dombi who helped lead the strategy in this case, the International Franchise Association and the Home Care Association of America which joined in the litigation and the law firm of Littler Mendelson which had been hired to bring the suit.

To read the decision, click here: https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2014cv0967-32

HCAF will continue to keep members up to speed on all the latest developments as they occur. We will be keeping a log of the events, marked with dates at the link below for members.

Click here for more details on the lawsuit and a log of the most recent events.

P.S. With all of these changes happening very quickly, we strongly suggest members attendHCAF’s 2015 Winter Mini-Conference in Ft. Lauderdale, January 21-22. There is so much change occurring at a rapid pace, that HCAF feels it is imperative that we offer an educational event to supplement our Annual Conference and offer increased learning opportunities, on important topics such as this, more often throughout the year. Registration is still open, but space is filling fast!

Click here for more details on HCAF’s 2015 Winter Mini-Conference and make sure to register today!

Judge Allows Face-to-Face Lawsuit to Move Forward

January 7, 2015

Another huge win for home care! This particular ruling could have major implications…..

  • CMS approaching our industry with a settlement offer on the thousands of denied claims that are being held in limbo at the ALJ level because of the F2F narrative, so start considering what you might accept on your denied claims.
  • It could help slow down or lessen the intensity of the next round of F2F audits from RACs and MACs. They are gearing up and this may take a little wind out of their sails.
  • It strengthens our industry and gains us respect and leverage on a host of other critical issues. This will help us!

We are very grateful to all home care providers who choose every year to support associations like NAHC and HCAF. It is your dues dollars that made this happen. Thank you.  

January 5, 2015

Federal Court Rules in Favor of Homecare

Clears the Way for NAHC’s Face-to-Face Lawsuit to Go Forward

Today, a federal district court issued a resounding victory for the National Association for Home Care & Hospice (NAHC) and the home health agencies, Medicare participating physicians, caregivers, and beneficiaries it represents. The U.S. District Court for the District of Columbia held that it has the power to hear a challenge to the validity of a Medicare rule that requires physicians to provide a “narrative” explaining why the patient meets Medicare coverage standards for home health services. The court issued an order denying Medicare’s effort to have the lawsuit dismissed by the court.

The Centers for Medicare and Medicaid Services (CMS) issued a face-to-face rule that physicians had to lay eyes on patients and certify under penalty of law that that they were eligible to participate in Medicare and, more specifically, were “homebound” and needed “skilled care.” In addition, the rule required physicians to write a detailed narrative explaining the reasons why they thought this was true. This new requirement caused widespread chaos, spurred a physician rebellion, and in the end deprived many seniors from receiving the care to which they were entitled under the Medicare home health benefit.

NAHC convinced groups representing seniors and the disability community to join together with physician organizations and thereby succeeded in convincing a majority of the Senate to send a letter intervening on NAHC’s side in this matter. NAHC also filed suit in federal district court to overturn the onerous rule. The result was that CMS withdrew the physician narrative requirement which would have been effective January 1, 2015.

NAHC asked CMS to give the decision retroactive effect and pay claims that were denied between 2011 and 2014, but CMS denied to do so. NAHC made other appeals to CMS to settle the suit which it could have done by paying some $250 million owed to home health agencies for care they gave to Medicare patients between 2011-2014. This gave NAHC no choice but to proceed with the litigation.

In today’s action, the court ruled against the government on its motion to dismiss this case. The government attorneys had interposed numerous reasons, both substantive and procedural, as to why the case should not go forward, all of which were turned aside.

The court held that it would be futile for home health agencies to pursue endless administrative appeals challenging the requirement as Medicare had made it clear that it would reject all such appeals. By denying Medicare’s Motion to Dismiss, the legal validity of the narrative requirement will be fully reviewed by the federal court.

Medicare had filed a Motion to Dismiss the lawsuit arguing that administrative appeals had to be fully completed before a court had the power to hear a Medicare dispute. Medicare also argued that the case should be dismissed because the narrative requirement, on its face, was a valid interpretation of the authorizing law in the Affordable Care Act. Federal District Judge Christopher R. Cooper rejected both of these defenses.

Judge Cooper found that it would be futile for home health agencies to pursue administrative appeals because Medicare had definitively stated that it considered the requirement to be valid. NAHC had argued that Medicare had issued a final decision on the validity of the rule numerous times including when Medicare officials met with NAHC as well as in its issuance of the recent rule change that eliminated the narrative requirement. Judge Cooper agreed. He described the challenged policy as “embedded” and that “nothing indicates that administrative appeals might result in the agency overturning its regulation.”

While rejecting Medicare’s attempt to escape judicial review of the face-to-face narrative requirement, the court did grant dismissal of two additional claims in the lawsuit. NAHC also challenged the ambiguity of the interpretive guidance issued by the Centers for Medicare and Medicaid Services along with its failure to waive the recoupment of alleged overpayments under the Medicare “without fault” provision. On those matters, the court found that the factual complexities warranted a review of individual claim determinations at the administrative levels prior to any judicial intervention.

NAHC and Medicare will now move forward with the lawsuit. The next steps would include the filing of cross-motions for Summary Judgment. Summary Judgment is the equivalent of a trial on the merits of the claims where there are no material issues of facts in dispute. Here, NAHC argues that the plain language of the law prohibits Medicare from adding the burdensome narrative as a documentation requirement. The law itself only permits Medicare to require that a physician document that a face-to-face encounter occurred and when. As such, it is claim based on the language of the law itself and does not involve any facts other than that Medicare requires more documentation.

NAHC continues to litigate the dispute in spite of Medicare’s rescission of the narrative requirement to address the past claim denials and those denials that may still come involving home health services provided prior to January 1, 2015. If the lawsuit is successful, Medicare would be required to reopen and pay any claim previously denied for an insufficient narrative and stop any further claim reviews related to the narrative requirement.

NAHC continues to advise home health agencies to consider appealing any narrative-related claim denials while the lawsuit is progressing. Such action will preserve the opportunity to have the claims reviewed by Administrative Law Judges and also allow for easy identification of claims that may be subject to reopening if the lawsuit is successful.

“This great victory in federal court means that Medicare patients, physicians, and the home health community will have their day in court,” said NAHC President Val J. Halamandaris. “It is a clear signal that a federal judge also does not see why a rule which CMS had invalidated effective January 2015 should be honored for the years 2011, 2012, 2013, and 2014. There is no reason why the home care community should not be paid for the services it rendered in good faith to Medicare home health beneficiaries.”

Bill Dombi, NAHC’s Vice President for Law, appealed to CMS to save Medicare the cost of the trial. “We urged them to do the right thing. The right thing is to pay these claims. NAHC intends to pursue this litigation until CMS agrees to do so.”

Judge Places Temporary Restraining Order on New Companionship/Overtime Rule, Delaying Implementatio

December 31, 2014


Please note the really good news below. Help pass this on to other homecare providers who are members and most importantly pass it on to those providers who are not members of HCAF. This in an excellent example of what Trade Associations (National and State) can accomplish when they work together and are supported by a connected, engaged industry. With your continuing support we will gain even more ground and additional wins in 2015! Thank you all and I hope each of you have a wonderful and safe New Year’s celebration.

December 31, 2014


U.S. District Court Issues Order Blocking a New Department of Labor (DOL) Rule Which Would Redefine Companionship Services

Andrea Devoti, Chairman of the National Association for Homecare and Hospice (NAHC) today hailed the decision of the U.S. District Court for the District of Columbia which issued a Temporary Restraining Order (TRO) blocking DOL from enforcing a proposed new definition of “Companionship Services.”

“This means that our most vulnerable citizens get at least a temporary reprieve from what would otherwise have become a significant cost barrier to their paying for help at home for their chronic diseases.  Without this relief many seniors would be pushed into institutional care,” said Ms. Devoti.

This decision follows on the heels of a December 22 ruling by this same Court which restored the rights of home care consumers to benefit from the “companionship services” and “live-in” exemptions regardless of whether their caregivers were employed by persons receiving the care or by a home care company.

The lawsuit challenges a rule that would have significantly changed a longstanding 40 year old Federal overtime rule known as the ‘companionship exemption’ under the Fair Labor Standards Act.  The new rule would have defined ‘companionship services’ to be primarily “fellowship” and “protection”.  Under the new DOL rule, the exemption would not have applied if home care workers serving patients gave more than incidental personal care services. The proposed rule would have required all current caregivers to be paid overtime compensation in almost all cases.  This change would have led to higher costs which would have to be borne by infirm individuals or by the states and federal government through financially strapped programs such as Medicaid.

Following the court’s ruling on December 22, NAHC asked the court to stay the effective date of a new narrow definition of “companionship services”, which seemed to have the intent to eliminate two exemptions to overtime rules which benefit patients and home care employers.

In its motion for a temporary stay, NAHC argued that home care recipients, companies, employees, and payers of services would face a risk of irreparable harm if the DOL rule went into effect. NAHC also explained that it would be likely that its claims would succeed on the merits and that the public interest would be best served by maintaining the status quo on overtime exemptions while the lawsuit proceeds.

The effort for temporary relief was supported with detailed affidavits of likely harm submitted by two disability rights advocacy groups, The Centers for Independent Living and ADAPT along with the Kansas state Department on Aging which is concerned about the financial stability of its home care programs if overtime compensation is required.

The next phase of the case will occur quickly, as the court has scheduled a briefing and a hearing on whether a Preliminary Injunction should be issued. A TRO can be in force for no more than 14 days while a Preliminary Injunction can be in effect until a final ruling on the case.

The hearing is set for January 9. The judge indicated that he may rule on the preliminary injunction at the hearing, but he would rule no later than January 13.

During the time in which the TRO is in effect, home care companies can continue to pay home care aides and personal care attendants without added overtime compensation (as per usual in Florida). Home care companies are advised to consult competent counsel to determine if they qualify to use the exemption. If the requested injunction is granted on January 9, the exemption from overtime will continue until the court’s final ruling or the Court of Appeals reverses the injunction. The Department of Labor has previously indicated that it would appeal any adverse ruling of the court.

“Obviously some well intentioned people in the DOL put forth a rule which they said would be good for patients, helpful to homecare employees, and the companies that hire them, and equally good for State/Federal programs such as Medicaid. The fact is that the proposed regulation would have had exactly the opposite effect on every category.   For this reason NAHC applauds the US District Court for its rulings  and will continue to lead the effort  in support of the companionship rules as they have been in effect for more than 40 years,  and which have been sustained by a unanimous vote in the U.S. Supreme Court,”  said Chairman Devoti.

November is National Home Care Month – Honoring All the Professionals that Serve Patients and Their Families

November 14, 2014



Every November, HCAF celebrates National Home Care Month by working to create more awareness for the importance of home and community based services, as well as giving extra recognition to the nurses, therapists, aides, administrators, and other staff members that contribute to the compassionate care of seniors and the disabled in their homes.


HCAF is encouraging our members to get involved in these efforts as well. Here are some of the ways you can help:


Members are also encouraged to join HCAF’s advocacy efforts. HCAF has begun organizing meetings with legislators in order to help build relationships between HCAF members and their local elected officials. Stay tuned to future issues for specific times and dates in your area.


You can also support home care by giving to the Home Care PAC during National Home Care Month. PAC funds are used to help further the goals of the Home Care industry, such as eliminating the home health quarterly report, negotiating higher rates, and more.


Whether it be certified agencies, private-duty, or companionship services, HCAF would like to recognize all of our members for the outstanding work they do to keep patients in the setting they prefer the most to receive care, their home.