Posts Tagged ‘rebasing’

Rebasing Relief Bill Introduced in the U.S. House of Representatives

May 16, 2014

Congressman Ralph Hall (R-TX) recently introduced the Medicare Home Health Rebasing Relief and Reassessment Act (H.R.4625). The bill seeks to suspend CMS’ flawed rebasing rule for 12 months and require that CMS reassess the rule and submit a report to Congress on alternative rebasing methods, including methods offered by stakeholders. 

The National Association of Home Care and Hospice and the Texas Association for Home Care & Hospice were involved in drafting the legislation and in getting H.R. 4625 introduced. HCAF has pushed for the passage of relief against these unfair and punitive across-the-board cuts to home health and supports this legislation.

In February, Rep. Hall – along with a bipartisan group of his colleagues – sent a letter to House Speaker John Boehner (R-OH) and House Minority Leader Nancy Pelosi (D-CA) urging congressional action to postpone CMS’ Final Rule on home health rebasing and require that CMS re-evaluate the rule.

The letter strongly reinforces the points that HCAF has been stressing since the beginning of the rebasing debate, namely that:

“If this rule is not postponed and appropriately evaluated, according to CMS projections almost half of the home health industry will be paid less than their costs. Current industry data shows that as many as 73% of home health agencies across the country could be out of business when the rule is fully implemented…

The Final Rule…clearly does not take into consideration the appeals made by the U.S. Congress and interested stakeholders. The Final Rule unnecessarily rebases payment rates at the maximum cut permitted under the Affordable Care Act: a cut of -3.5% per year over each of the next 4 years, totaling an unprecedented cut to Medicare home health funding of 14% by 2017…

Urgent action is needed as the Final Rule took effect January 1, 2014.Home health plays an essential role in our health care system by serving the Medicare population with skilled nursing and habilitation services in the least costly setting – the home, and it is imperative that we protect access to care through informed and reasonable rulemaking.”

The February letter outlines – and the legislation that was recently introduced would – provide relief from the rebasing rule while compelling CMS to look at alternative methods of rebasing. 

HCAF strongly encourages all of its members to take a moment to contact their Representatives in the House and ask that they cosponsor this important legislation.  It is especially important to get Democratic lawmakers to sign-on as a cosponsor to maintain a bipartisan balance.

For contact information, please click here.

Action Needed Ahead of Final Rule on Rebasing

November 15, 2013

With the publication of CMS’s Final Rule on 2014 Prospective Payment System (PPS) Home Health Rebasing arriving in less than two weeks, HCAF has been told that a little more pressure on CMS is needed at this crucial juncture. There is still time to contact your legislator and urge them to OPPOSE 14% in cuts to the medicare home health rate! By slashing rates by 3.5% per year for four years beginning January 1st, 2014, CMS will reduce all 50 states and the District of Columbia to negative average Medicare margins by 2017. It goes without saying that this would be catastrophic to the home health industry!

HCAF is partnering with the National Association for Home Care and Hospice (NAHC) in our legislative efforts to eliminate completely or at least reduce the impact of this rule, but we need your help!

Please use the links below to access NAHC’s website to send an email to your elected officials in Washington letting them know you, their constituent, need them to preserve home health for the patients, employees, and operators of home health in their district.

Feel free to add a personal message to the informative letter sent on your behalf on the right-side of the linked website.

By entering your address and clicking “Send”, this message will be automatically sent to U.S. Senators Bill Nelson and Marco Rubio as well as the Congressman or Congresswoman from your district.

HCAF also encourages you to write to the White House as well!

Write Your Legislators

Write to the President

HCAF is here to advocate for home health, but we cannot do it without your help. Please take a short moment and let your voice be heard in order to make sure home care is not slammed with this massive cut.

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Goverment Shutdown Delays Release of CMS Final Rule on Home Health Rate Rebasing

October 25, 2013

Yesterday, the Centers for Medicare and Medicaid services delayed the release of the CY 2014 Home Health Prospective Payment System (PPS) Final Rule for nearly a month.

This is a delay to the original issue date of November 2nd that was announced. CMS is still a determining the effects of the partial government shutdown on their ability to complete 2013 Medicare fee-for-service payment regulations including the home health PPS rule and physician fee schedules.

The current proposed rule would cut medicare payments by 3.5% per year for four years, leading to an overall cut of 14% to the home health medicare payment rate. Despite the delay in announcing the final rule, it is still scheduled to take effect January 1st, 2014.

HCAF intends on using this additional time to educate our members at our Fall District Meetings (running from 11/12-11/25) on how they should prepare for the different possible outcomes of this final rule.

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Industry Reps Meet with Key Congressman to Discuss CMS Proposed Rule

July 12, 2013

FL-USCong_Bilirakis-2013-07-12Home care industry representatives today met with U.S. Representative Gus Bilirakis (R-Tarpon Springs), a four-term Tampa Bay area congressman who serves on a key health care committee in Congress.

BAYADA Home Health Care’s Jeanne Barton and Carson Barnes and HCAF’s Kyle Simon met with Rep. Bilirakis to discuss the recent CMS proposed rule, which calls for a 1.5 percent cut Medicare home health reimbursement rates in 2014. The rule also includes a 3.5 percent annual cut over four years to rebase Medicare rates, as required by the Affordable Care Act. The discussion gave industry representatives the opportunity to highlight to Rep. Bilirakis the importance of home health care and the role it plays in offering high quality, cost effective care for more than 300,000 Florida seniors each year.


Home Health Index Hits a Seven-Month Low

July 8, 2013

Stoneridge Partners announced that the home health index, which is comprised of the four public home health care agencies, hit a seven-month low following CMS’ June 27 announcement of proposed Medicare home health payment rates for 2014. The proposed would set rebasing at the maximum reduction of 3.5% for each of the next four years.

Although this is just a proposal it sent a shock wave to the stocks in our Stoneridge Partners Home Health Index, causing the index to drop over 10% in just a few hours, something Stoneridge Partners noted they have not seen in their 10 years of tracking.

Until the announcement, the HH Index had been up, however it’s now down about 7% for the month and 5% YTD. On the good news front, the index is still up from a year ago.

Here are the results for the HH Index: (more…)

CMS Proposes 1.5 Percent Cut to Home Health Payments

June 27, 2013

The Centers for Medicare & Medicaid Services (CMS) today announced proposed changes to the Medicare home health prospective payment system (HH PPS) for calendar year (CY) 2014 that would foster greater efficiency, flexibility, payment accuracy, and improved quality. Based on the most recent data available, CMS estimates that approximately 3.5 million beneficiaries received home health services from nearly 12,000 home health agencies, costing Medicare approximately $18.2 billion in 2012.

In the rule, CMS projects that Medicare payments to home health agencies in calendar year (CY) 2014 will be reduced by 1.5 percent, or $290 million based on the proposed policies. The proposed decrease reflects the effects of the 2.4 percent home health payment update percentage ($460 million increase), the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, and the non-routine medical supplies (NRS) conversion factor ($650 million decrease), and the effects of ICD-9-CM coding adjustments ($100 million decrease).

In addition, the rule proposes routine updates to the HH PPS payment rates such as updating the payment rates by the HH PPS payment update percentage and updating the home health wage index for 2014. (more…)

Analysis: Florida Home Health Medicare Margins on Steep Decline

June 6, 2013

The Home Care Association of Florida in coordination with the Partnership for Quality Home Healthcare today released data demonstrating that the rebasing of Medicare home health payments within the proposed Home Health Prospective Payment System (HHPPS) rule for 2014 will negatively impact Florida’s home health sector and the 342,570 vulnerable Medicare beneficiaries receiving home health by driving Medicare margins to an all-time low. Leaders are urging regulators to carefully consider home health sector’s current-law economics when implementing this policy.

Under the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) is directed to rebase home health payments between 2014 and 2017 by a percentage determined appropriate by the Secretary.  This percentage is to be implemented in equal increments during each year from 2014 through 2017. (more…)

MedPAC Reissues 2012 Recommendations

January 14, 2013

Last week, the Medicare Payment Advisory Commission met to finalize its 2013 Medicare recommendations to Congress. MedPAC reiterated its 2012 recommendations including the following:

  • The Secretary of the U.S. Department of Health and Human Services, with the Office of Inspector General, should conduct medical review activities in the counties that show aberrant home health utilization. The Secretary should implement the new authorities to suspend payments and the enrollment of new providers if they indicate significant fraud.
  • The Congress should direct the Secretary to begin a two-year rebasing of home health rates and eliminate the market basket increase.
  • The Secretary should revise the home health case mix system to rely on patient characteristics to set payments for therapy and non-therapy services and should no longer use the number of therapy visits as a payment factor.
  • The Congress should direct the Secretary to establish a per-episode copayment for HH episodes that are not preceded by hospitalization or post acute care use. (more…)

MedPAC Offers Positive Comments for Future of Home Health

December 14, 2012

The Medicare Payment Advisory Commission (MedPAC) met in Washington, D.C. last week for its annual review of draft recommendations for legislative consideration related to Medicare providers. HCAF’s Bobby Lolley and Monica Smith were in attendance, at which the Commission reviewed Medicare home health services. (more…)

Senate Budget Committee Considers 20 Percent Home Health Copay

April 25, 2012

The U.S. Senate Budget Committee Chair, Sen. Kent Conrad (D-ND), recently submitted a budget proposal for consideration by his committee patterned after the December 2010 Simpson-Bowles Deficit Commission recommendations, which includes establishing a uniform 20 percent Medicare copay for all services, including home health and hospice. The committee met to make opening statements about the proposal; Conrad plans to reconvene the committee at a later date to discuss the plan in more detail.

The 20 percent copay for home health would mean $600 per 60 day episode of care. The average cost for hospice patients is over $10,000. This would mean a hospice copay of over $2,000. Studies have shown that copays would threaten access to care and cause a big increase in more costly hospital and nursing home care. (more…)