Copays and Cuts on the Horizon: Rally Your Staff, Colleagues, Patients and Their Families to Save Our Industry!

This week, President Obama released his deficit reductions recommendations for the Joint Select Committee on Deficit Reduction, also known as the “super committee”. President Obama’s proposal is intended to reduce the deficit by $3 trillion over the next ten years. It includes $320 billion in savings from federal health programs, including $224 billion from Medicare and $66 billion from Medicaid. These reductions are in addition to the $1 trillion in savings from spending caps enacted by the debt ceiling package that was signed into law this summer.

What Does This Mean for Home Care?

In his proposal, the President calls for a $100 Medicare home health copayment beginning in 2017 for new beneficiaries who become eligible for Medicare in 2017 and thereafter. The copayment is per episode, and only applies to episodes with five or more visits not preceded by a hospital or other inpatient post-acute care stay.

The President anticipates a home health copayment would produce $400 million in savings over the next decade. It is similar to the Medicare Payment Advisory Commission’s (MedPAC) recommendation adopted earlier this year, but with a later implementation date and lower copay (MedPAC recommended $150).

In addition, the proposal references eliminating payment updates for certain post-acute care providers as recommended by MedPAC, which recommended no home health inflation update for 2012. It remains unclear if the payment freeze referenced in the President’s proposal would extend beyond next year, or if it would accelerate the rebasing of home health rates (scheduled to begin in 2014 and be phased in over four years). The President also proposed approximately $42 billion in cuts for post-acute care providers, excluding hospice, but it’s unclear how much will come from home care.

What is the Super Committee and Why Does it Matter?

The Budget Control Act of 2011 established the Joint Select Committee on Deficit Reduction, aka the “super committee”, earlier this summer. As you likely recall, the federal government was considering raising the debt ceiling in order to pay its bills, so Congress and the President came to an agreement with the Budget Control Act that reduced the deficit by $900 billion off the bat.

In addition, the Budget Control Act established a committee to be charged with the task of reducing federal spending by an additional $1.2 to $1.5 trillion. The committee has until Nov. 23 to vote on a plan, which, if approved, will need approval from Congress followed by the President’s signature. If the committee does not come up with a plan for Congress to pass, a so-called “trigger mechanism” would enact $1.2 trillion in automatic spending cuts to serve as the second installment of deficit reduction measures, including a two percent cut to Medicare provider payments. (It’s worth noting that a two percent cut would likely have less of an impact on home health agencies and exclude a copayment, and fortunately the possibility of the committee not coming to an agreement on cuts is very real considering the heightened partisanship in Congress.)

Six members from the Senate and six from the House of Representatives were appointed by congressional leadership to serve on the super committee. None of these 12 members are from Florida. However, in addition to President Obama’s recommendations to the committee, members of Congress serving on committees with jurisdiction over Medicare and Medicaid issues have until Oct. 14 to submit their recommendations to the super committee. Four of Florida’s 27 members of Congress sit on one of these very influential committees:

What Can We Do?

Over the past several months, HCAF has alerted you to threats of copays and further Medicare cuts, but the reality of both are finally here. If implemented, the impact on agencies and the industry as a whole will be devastating. Now is the time for the home health industry to unite and raise our voices on behalf of our agencies, our employees, our patients and their families!

Although the Democrats and Republicans in Washington have not agreed on much lately, we cannot afford to bank on partisan bickering to stand in the way of Congress enacting MedPAC’s recommendation to impose home health copays and more cuts.

Between now and Dec. 23, home care must not relent on calling on Congress to oppose home health copays and further cuts. Make it a weekly or daily exercise to send a letter, make a phone call or even schedule an appointment with your congressman’s or senator’s local office and voice your concerns face-to-face.

Click here to contact Senators Bill Nelson (D) and Marco Rubio (R) and your U.S. representative with the message that the home care industry and Florida’s seniors cannot afford a home health copayment.

HCAF also encourages you to reach out to your senators or representative by phone. To do so, call the U.S. Capitol switchboard at (202) 224-3121 (save it in your phone and call often!) and when connected to their office, ask to speak to the Medicare staff person. Your insight and input makes a difference – make the call today and as many times as you can!

With the nation’s second largest Medicare population, we must stand up for those who do not have a voice in this debate! Send this message to your staff, colleagues and patients and urge them to get involved in this fight for home care!

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One Response to “Copays and Cuts on the Horizon: Rally Your Staff, Colleagues, Patients and Their Families to Save Our Industry!”

  1. Super Committee Struggles to Find Budget Cuts – Ask Congress to Oppose Home Health Copays and Further Cuts! « HCAFeNews Says:

    […] Last month, HCAF called on Florida home care professionals to contact Congress in opposition to home health copayments and more cuts to Medicare home health, as recommended to Congress’ super committee by President Obama. […]

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