HCA Announcement: CMS Final Rule Cuts Home Care

The Home Care Alliance distributed a press release spotlighting the Final Rule from the Centers for Medicare and Medicaid Services (CMS) that cuts home health payments and implements barriers between patients and the care they need.

Although some flexibility was gained through advocacy on the proposed rule, the results of the final rule are still damaging to the industry. Federal elected officials for Massachusetts were instrumental in helping to achieve some of that flexibility, but more work will need to be done as CMS plans to re-evaluate its assessment methodology in making any case mix adjustnments for 2012.

New Medicare Final Rule Cuts Home Care
Rule Scaled Back from Original Proposal, Still Damaging to Home Health Services

Home care agencies and organizations across the country knew that nearly $40 billion in cuts to Medicare home health services over the next decade were going to be included in the Affordable Care Act, but the home health industry did not expect an additional $960 million reduction in 2011 alone.

That extra cut was the result of a new final rule from the Centers for Medicare and Medicaid Services (CMS) that also will place a number of restrictions on those attempting to certify, administer, and receive home health services.

“We understand the federal government’s is trying to save Medicare by slowing growth in spending, but the degree of cuts contained in this rule are too much, too fast,” said Home Care Alliance Executive Director Patricia Kelleher. “At time when all the evidence shows that patients being admitted to home health are sicker and in need of even greater resources Medicare is reducing payments by almost five percent. This is on top of a 2.79 percent cut last year. The industry cannot continue to sustain cuts upon cuts.”

Also new to the Medicare program, CMS is now requiring a face-to-face visit between physician and patient before a home health plan can be certified. The timeframe for such a visit was extended to 90 days before the start of care or 30 days after the start of care, which is an improvement on the 30-day/14 day timeline in the original proposed rule. However, this new rule may still be a barrier to care for patients too ill to get out to a doctor or unable to get a timely appointment.

Much of the proposed rule was meant to curb what Medicare sees as excessive growth of the program in some parts of the county. But imposing an across the board cut only makes the work of caring for people at home more difficult for the providers who have always played by the programmatic rules set by CMS.

“Working with Senator Kerry, the home health industry was able to negotiate a level of payment reform for home health in the Affordable Care Act that would have been sustainable over the next few years,” added Kelleher, “but the Medicare program has far exceeded what they were instructed to do by Congress.”

Massachusetts was the only state in the nation to have the entire federal legislative delegation – all Congresspersons and both Senators – sign a letter in opposition to the level of cuts in the CMS proposed rule.

Return to www.thinkhomecare.org.

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