Author: James Fuccione

Advocacy Alert: Home Health Care Access Protection Act

Please encourage your congressional legislators to add their names as cosponsors of the Home Health Care Access Protection Act (H.R. 5803; S. 3315) introduced by Reps. Jim McGovern (D-MA) and Walter Jones (R-NC) and Sens. Susan Collins (R-ME) and Russ Feingold (D-WI).

In light of the recent CMS rule that proposes to cut home health payments by 3.79 percent in 2010 and 3.79 in 2011 based on an unfounded allegation of “case mix creep,” this legislation is vitally important to preserve access to home health services because it would establish a fairer and more transparent process for evaluating case mix changes. Home health advocates also should ask their legislators to convey these significant concerns about payment cuts to CMS.

  • Click here and enter your address to find your federal legislators and their contact information. To access the text of the House bill and a list of House cosponsors, click here. To see the text of the Senate bill and a list of Senate cosponsors, click here.
  • If your legislators have not yet cosponsored H.R. 5803 (the House bill) or S. 3315 (the Senate bill), please contact their offices and encourage them to do so. When calling, ask to speak with the staffer who handles Medicare issues. For talking points, click here.
  • To send an email on this issue to your members of Congress using the NAHC Legislative Action Network, click here. We encourage you to edit the sample email provided there by adding information about your own background and experience and the impact these payment cuts could have on home health patients in your state.

Return to www.thinkhomecare.org.

NY Times: Cutting Home Care Today Hurts State Budgets Tomorrow

Continuing on an article written on how cash-strapped states are cutting home care services, the “New Old Age” blog of the NY Times highlighted what home care and home health advocates have been telling state and federal elected officials for years: People prefer to live at home rather than an institutional facility, which costs more taxpayer money anyway.

To read the New Old Age blog on home care cuts, click here.

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Nurse Delegation Bill Moving Through House of Reps

The Home Care Alliance’s state bill on nurse delegation, known as S.860, An Act Relative to Home Health Aides, is moving from one House committee to another on its way to what will hopefully be a vote before the full 160-member House of Representatives.

The legislation has moved to the House Committee on Bills in the Third Reading and we still need your help in advocating. Send a message from our Legislative Action network (top message) today!

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Ask Congress to Support Home Health Planning Improvement Act

The National Association for Home Care & Hospice (NAHC) is planning a “virtual lobby day” on July 22 in an effort to boost cosponsors for the Home Health Care Planning Improvement Act (S.2814, H.R.4993). The legislation would allow Nurse Practitioners (NP’s), Clinical Nurse Specialists, and Physician Assistants (PA’s) to certify and make changes to home health care plans.

The House version has 80 cosponsors and the lead sponsors, Congresswoman Allyson Schwartz (D-PA) and Congressman Walter Jones (R-NC), are seeking to get that number up to 100 prior to the August recess.

Click here and enter your information to find your federal legislators and their contact information. To access the text of the House bill and a list of House cosponsors, click here. To see the text of the Senate bill and a list of Senate cosponsors, click here.

A message is also available on the Legislative Action Network (second to last prepared message) for those looking to email and not call.

Return to www.thinkhomecare.com.

NY Times: Making Homes Safer for Dementia Patients

The Visiting Nurse Service of New York has come up with a checklist for making homes safer for Alzheimer and dementia patients, which was highlighted in “The New Old Age: Caring and Coping” blog in the NY Times.

According to the blog, the list was complied by Cathy Castronova, a registered nurse and case manager with the service’s affiliate, Partners in Care, who assesses the homes of older people for safety and has taught numerous classes on helping seniors remain safe at home.

Return to www.thinkhomecare.org.

CMS Publishes 2011 PPS Rate Update

The Centers for Medicare & Medicaid Services published the 2011 Home Health Prospective Payment System (PPS) Update Rule.

Combining the effects of a market basket update, a wage index update, reductions to the home health prospective payment system (HH PPS) rates to account for increases in aggregate case-mix that are unrelated to underlying changes in patients’ health status, and other provisions mandated by the Affordable Care Act, today’s rule proposed a 4.75 percent decrease in Medicare payments to home health agencies (HHAs) for calendar year (CY) 2011.  The rule also changes the existing home health outlier policy, with total outlier payments not to exceed 2.5 percent of the total payments estimated for a given year. HHAs are also permanently subject to a 10 percent agency-level cap on outlier payments.

Additionally, the proposed rule includes provisions mandated in the health care reform act, which states that a physician must document a face-to-face encounter with the patient, prior to certifying a patient’s eligibility for the Medicare home health benefit and that a hospice physician or nurse practitioner has seen a patient prior to recertifying the patient’s eligibility for hospice services.

In a separate notification, hospices serving Medicare beneficiaries will see an estimated 1.8 percent increase in their payments for fiscal year (FY) 2011.   The estimated hospice payment increase is the net result of a 2.6 percent increase in the “hospital market basket,” an indicator of input price increases. This is an offset by an estimated 0.8 percent decrease in payments to hospices due to updated wage index data and the second year of CMS’ 7-year phase-out of its wage index budget neutrality adjustment factor (BNAF).

A link to the notice, along with accompanying documents can be found here. Information on submitting comments is available within the notices.

Return to www.thinkhomcare.org.

Nurse Applauds Congressman McGovern for Visit

In appreciation of Congressman Jim McGovern’s recent home visit with Community VNA of Attleboro, the nurse who the Congressman accompanied wrote an Op-Ed praising McGovern’s support of home health issues. The editorial appears here in the Attleboro Sun-Chronicle.

Sandy Legg-Forgiel was the registered nurse and telemonitoring coordinator for Community VNA who brought Congressman McGovern on the visit to the home of a patient on telehealth services. In addition to his existing support, McGovern agreed to sign on to an initiative that would expand the use of remote patient-monitoring services.

Congressman McGovern is a leading champion in Washington DC for the home health industry having established the Home Health Working Group in Congress and has filed or signed on to several pieces of legislation throughout his career that were of benefit to home care.

Return to www.thinkhomecare.org.

Metrowest Daily News Promotes HCA Accreditation Program

The Home Care Alliance’s new Accreditation Program, which was recently announced at an event for members at Hebrew SeniorLife Home Care, is already gaining attention.

The Metrowest Daily News ran a story on the program that is meant to promote a series of standards for private duty home care agencies. The article mentions that, “The new standards cover areas such as recognizing and reporting elder abuse, ensuring services and costs are clear to customers up-front, and establishing procedures for clients to report problems with aides.”

The article states further a need for such standards as “Locally, the population of residents 75 and older was measured at nearly 26,000 in the 2000 Census, but that number is expected to grow to more than 40,000 by 2030, according to data from the MetroWest Community Health Care Foundation.”

The Metrowest Daily News covers 27 towns west of Boston, including Framingham.

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Boston Globe: Home Health Jobs Among Fastest Growing

The Boston Globe’s website, Boston.com, ran a piece in their “Jobs” section on the 30 fastest-growing jobs by 2018.

Many health care-related jobs show up on the list, but home health aides came in at number three.Physical and Occupational Therapy aides also came in high on the top 30, as were home care and personal aides, which ranked fourth.

The Globe acquired data to determine the rankings based on the Bureau of Labor Statistics.

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HCA Offers Comments on PECOS

The Home Care Alliance joined agencies and organizations from across the country in submitting comments on the Interim Final Rule requiring physicians enroll in PECOS (Provider Enrollment, Chain and Ownership System).

The Alliance submitted comments because the regulation change, although directly related to physicians, would prohibit home health agencies from submitting claims to Medicare for reimbursement if the physician was not enrolled in the online PECOS system.

Due to inquiry from federal elected officials, letters and comments, the Centers for Medicare and Medicaid Services (CMS) issued a notice clarifying that they will, “for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.”

The notice continued that “While the regulation will be effective July 6, 2010, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS.  However, until the automatic rejections are operational, providers should not see any change in the processing of submitted claims, they will continue to be reviewed and paid as they have historically been reviewed and paid.”

The Home Care Alliance’s comments call for a delay in the implantation of the regulation to October 1, 2010 and also to hold home health agencies and other Medicare part B providers harmless for claims submitted prior to that date for services ordered by physicians not listed in PECOS.

To take action, fill out this form and send an email to your federal elected officials.

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