HCA Goes to Washington

The Home Care Alliance and member agencies will join other associations and agencies from across the country for the annual NAHC March on Washington.

The annual conference provides a chance to lobby members of Congress on issues of concern and thank those who have supported our causes. For those who are not traveling to Washington DC, the Alliance has made materials available (see below) to use as a guide for a “virtual lobby day” on March 27th when HCA and members visit with the state’s congressional delegation.

Pre-written advocacy messages are available to send off on the virtual lobby day under “Federal/National Issues” on the Alliance’s Legislative Action Center and click any messages that are of concern or interest. The messages will automatically be sent to the correct member of Congress once the online form is filled out asking for contact information. There is also an option to “compose your own message” near the top of that webpage.

If HCA members and advocates choose to contact their

federal representatives by phone, the Alliance has assembled the following materials and fact sheets on some of home care’s priorities, but we invite you to share your own issues and concerns as well.

• Home Care Cuts Fact Sheet
• Block Home Care Co-Pays
• Home Care Legislative Priorities (ask your member of Congress to support these proposals)
• Support National Moratorium on New Agencies

Finally, be sure to follow the Alliance’s activity in DC, including photos and updates, on Twitter.

Return to www.thinkhomecare.org.

US House/Senate Approaching Deal on Delaying Physician Cuts, Payroll Tax

House and Senate leaders have agreed on legislation to be voted on by their respective colleagues that delays a cut to Medicare fees to physicians.

By passing that legislation, physicians will avoid a 27 percent cut for another 10 months, the payroll tax holiday will be extended for one year, and unemployment insurance will be extended. According to the National Association for Home Care & Hospice, the physician fix has to be offset, but the proposal does not include any cuts to home care or hospice and does not include any home care copay.

What it does include is cutting Medicare bad debt payments for hospitals and nursing homes by about $6.9 billion over ten years; cutting clinical lab payments by $2.7 billion; rebasing Medicaid Disproportionate Share Hospital payments to save more than $4 billion; cutting the Affordable Care Act (ACA) prevention fund by $5 billion; and eliminating extra federal money provided by the ACA to Louisiana Medicaid, saving $2.5 billion.

As reported in a previous newsfeed post, the President’s proposed budget does include home care cuts and copays, which, if approved, would come on top of scheduled cuts from the affordable care act and a 2% cut from the federal budget sequestration process.

Both the House and Senate are expected to pass the deal today (Friday, February 17) and the President will sign the bill into law as soon as it reaches his desk.

For more information on the “physician fix” and payroll tax legislation, see stories from the Associated Press,  CNN, and USA Today.

Return to www.thinkhomecare.org.

President Obama Releases Budget with Copays and Payment Impact for Home Care

President Barack Obama released his proposal for the Fiscal Year 2013 Federal Budget with a scaled back version of copayments for home health care as well as payment adjustments for all post-acute providers.

According to the President’s proposal, a home health copayment of $100 per home health episode would be established and would be applicable for episodes with five or more visits not preceded by a hospital or other inpatient post-acute care stay. This, the budget narrative continues, would ap­ply to new beneficiaries beginning in 2017. The President’s budget notes that this is consistent with a MedPAC recom­mendation to establish a per episode copayment, although MedPAC had recommended a more severe copayment of $150 per episode.

MedPAC’s recommnedation cited by the President’s budget team noted that “beneficiaries without a prior hospitalization account for a rising share of epi­sodes” and that “adding beneficiary cost sharing for home health care could be an additional mea­sure to encourage appropriate use of home health services.” This proposal is estimated to save approximately $350 million over 10 years.

According to the National Association for Home Care & Hospice (NAHC), the President’s Budget also includes a reduced Market Basket Index (inflation) update from 2014 to 2021. The proposed update reductions of 1.1 percentage points each year affect all post-acute providers. These reductions, NAHC states, would be in addition to the 2014 home health rate rebasing and the productivity adjustments starting in 2015. The President estimates this measure will save $63 billion over ten years taking into account the other adjustments for all post acute providers.

Additionally, the Independent Payment Advisory Board (IPAB), which was initially established in the Affordable Care Act, will be strengthened under the President’s budget proposal. The group is charged with keeping Medicare solvent by enacting cost-saving measures if Medicare spending exceeds certain levels. The President’s proposal essentially lowers those spending triggers.

The budget blueprint touts some of the fraud and abuse crackdown and prevention achievements the administration has made and advances suggestions for furthering that effort:

• Cre­ate new initiatives to reduce improper payments in Medicare;
• Dedicate penalties for failure to use electronic health records toward deficit reduction;
• Update Medicare payments to more appropriately account for utilization of advanced imaging;
• Re­quire prior authorization for advanced imaging;
• Direct States to track high prescribers and utiliz­ers of prescription drugs in Medicaid to identify aberrant billing and prescribing patterns; and af­firm Medicaid’s position as a payer of last resort by removing exceptions to the requirement that State Medicaid agencies reject medical claims when another entity is legally liable to pay the claim.
• Alleviate State program integrity reporting requirements by consolidating redundant error rate measure­ment programs to create a streamlined audit program with meaningful outcomes, while main­taining the Federal and State’s government abil­ity to identify and address improper Medicaid payments.

Finally, the President’s budget makes a commitment to follow through on the Department of Labor’s proposed rule on removing the so-called “companionship exemption” for allowing overtime and minimum wage protections.

For more information, view the President’s budget proposal here.

Return to www.thinkhomecare.org.