Alliance Statement on CMS’ Final Rule Slashing Home Health Care Payments

November 27, 2013

The following is a statement from the Home Care Alliance regarding the CMS Final Rule on Home Health Rebasing. The Alliance invites its members and advocates to share this with their local media:

In a final rule released last Friday, the Centers for Medicare and Medicaid Services (CMS) have implemented a home health payment that will result in a 3.5 percent cut per year for the next four years.

It would be easy based on history to view the recent final rule from the Centers for Medicare and Medicaid Services (CMS) as “another year, another cut.” This year, however, is different.

The home health industry has absorbed $78 billion of cuts since 2009, which will be executed over the better part of the next decade. Those cuts come from the Affordable Care Act, other CMS final rules over recent years, and sequestration. The latest cuts amount to an additional and an untenable 14 percent – or $22 billion – reduction over the next four years.

These total reductions since 2009 and including the CMS final rule are comparable to the combined 2013 budgets of the federal departments of education and homeland security.

With an aging population and home health agencies caring for sicker patients that are released from the hospital at an earlier stage of recovery, the federal Medicare program is making it nearly impossible for quality providers to continue delivering effective services that end up saving taxpayers by preventing costlier facility-based health care under these circumstances.

The Home Care Alliance of Massachusetts joined providers and associations from across the country, as well as many members of Congress, in urging CMS to revisit what they had proposed back in July. Those calls and letters went disregarded and it is evident that CMS is trying to attain a numerical target in their budget ignoring logic at the expense of American seniors who benefit from care at home. CMS claims the cuts amount to a 1.05 percent reduction, which is a slight improvement over the proposed rule, but the cumulative impact of continued cuts scheduled for 2015, 2016, and 2017 drive the cut deeper.

The Home Care Alliance will be assembling with other advocates in Washington DC and online in a campaign to persist in opposing the cuts from CMS.

About the Home Care Alliance:

With a mission to unite people and organizations to advance community health through care and services in the home, the Home Care Alliance of Massachusetts is a non-profit trade association and advocacy group representing the voice of the state’s home-based health and care services. Founded in 1969, the Alliance represents 200 home care and home health agencies. For more information, visit


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More on ‘The Agency Advantage’

November 27, 2013 published an excellent article by Rona S. Bartelstone, LCSW, BCD, CMC, describing the advantages of working with a home care agency as opposed to the risks and responsibilities of direct-hire:

As the employer, the individual or family paying for the private home health aide would be held liable for any work-related injury that occurs on the job. This can include the cost of all medical expenses and any disability payments that might become applicable.

Since the home-care industry is noted for work-related injuries, this can be a huge risk, especially if the caregiving tasks include lifting, transferring or bathing. There are also risks related to communicable diseases if the aide does not abide by universal precautions that are required by all licensed agency personnel.

Furthermore, the employer retains any liability that arises out of an injury to the person being cared for or any other person on the premises. If the home health aide were to cause an accident, for example, in which other family members suffered any harm or losses, the employer would bear the full responsibility for all costs and compensation.

The article also contains case examples that illustrate these advantages in real-world situations. It makes an excellent, long-form companion to the Alliance’s 4 Reasons to Choose A Home Care Agency brochure, which is always available at no charge.

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ODF on December 11th

November 26, 2013

Save the Date!

The next Home Health, Hospice & DME Open Door Forum is scheduled for Wednesday, December 11, 2013 at 2:00 PM Eastern Time. If you wish to participate, dial 1-800-837-1935; Conference ID: 70980706.

Tentative Agenda:

I. Announcements & Updates

  • Ordering & Referring Physician
  • Home Health Rule Publication
  • Q Code Requirement

II. Open Q&A

III. Special Breakout Session with Q & A Hospice Item Set (HIS) and upcoming Training. Session starts promptly at 2:40 p.m.

Visit the Open Door  Forum Website for more information.

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NB: The original post accidentally indicated that the forum was to be on December 11; the post has since been corrected.

Home Health ODF: Ask-the-Contractor Teleconference

November 22, 2013

National Government Service’s  Home Health Open Door Forum: Ask-the-Contractor Teleconference (ACT) is scheduled for Tuesday, December 10, 2013 from 1:30-3:00 pm  This teleconference will provide updates to the home health provider community and a forum for questions and answers. The ACT is an opportunity to speak directly to the contractor, so please have your questions ready for the contractors to answer!

Date: Tuesday, December 10, 2013
Time: 1:30-3:00 p.m. ET

Register for session

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Guest Post: Making the MOLST of Your Life

November 19, 2013

By: Jeanne M. Ryan, MA, OTR, MBA, CHCE
Executive Director VNA & Hospice of Cooley Dickinson

According to the Massachusetts Expert Panel on End-of-Life Care:

“What people want and need as the end of life approaches are things that have mattered to them throughout life, often now more intensely then ever: that their wishes and values are respected, that their symptoms are well controlled; that their dignity is maintained; and that they can spend as much meaningful time as possible with those they most love”.

And while 70 percent of Americans say they wish to die at home, surrounded by family, in Massachusetts the reality is exactly reversed: More than 70 percent die in hospitals or nursing homes, often spending their last days or weeks attached to high-tech life support machines. The choices that patients and their families make about care at this stage of life are extremely personal, but can only be made well if the full range of options is presented, explored, and considered with each patient individually. Read the rest of this entry »

Boston Children’s Hospital Releases Educational Videos for Families, Providers

November 15, 2013

A series of educational videos for patients, families and healthcare providers is being promoted by Boston Children’s Hospital regarding care of a central line in order to help decrease the number of CLABSI (Central Line-associated Blood Stream Infections).

Especially for agencies specializing in pediatric home health care, but applicable for all, these videos are a useful educational tool. The Alliance also posted the link on our Facebook page and encourage home care agencies to pass them along to patients and families that could be benefited.

More educational videos for home care agencies and family caregivers created by the Home Care Alliance are available on the Caregiver Video Resource Center that can also be found at our Home Care Month Webpage.

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Good News! HIPPS Codes for Medicare Advantage Claims Delayed

November 8, 2013

Health Insurance Prospective Payment System (HIPP)S codes on Medicare Advantage (MA)  plan claims will be delayed until July 2014 according to information from NAHC.  Bellow is an excerpt from a letter CMS sent to the health plan.

”MAOs and other entities were instructed that effective December 1, 2013 dates of service (DOS), the disposition for the HIPPS codes edits would be changed from ‘Informational’ to ‘Reject’ for any Skilled Nursing Facility (SNF) and Home Health (HH) encounters submitted without the appropriate HIPPS codes. The purpose of this notification is to let you know that the December 1, 2013 DOS ‘Reject’ edit will be delayed to July 1, 2014 DOS. The ‘Informational’ edit for HIPPS codes would remain in place until that time.”

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