Fiscal Cliff Deal Reached with No Home Care Cuts or Copays

In the waning hours of the federal legislative session, the Senate passed an agreement to avoid the fiscal cliff that was then approved by the House with none of the feared elements concerning home health care.

The bill extends tax rates for the vast majority of citizens along with a series of other tax-related extenders and unemployment benefits. It also includes a “doc fix” through New Year’s Eve 2013.

U.S. Capitol BuildingThe agreement was approved with bipartisan support and, according to the National Association for Home Care & Hospice (NAHC), there are no cuts to Medicare home health services or hospice care benefits, payments, or payment rates. No home health copays are in this bill and there are no Medicaid cuts affecting home care. Additionally, NAHC found that protection against the Medicare outpatient therapy cap is continued through December 31, 2013.

The “doc fix” is paid for primarily through cuts to hospitals with nearly $15 billion in a combination of coding adjustments and DSH payment reductions. ESRD payments are also affected by a reduction of $4.9 billion.

The CLASS program established to help finance long term care services through a voluntary insurance approach under the Affordable Care Act is repealed under the Senate bill. The repeal has no financial consequence as CMS earlier indicated that it would not implement the CLASS program due to its inability to assure financial viability.

NAHC also notes that a very important provision in the Senate bill is the establishment of a Long Term Care Commission that will be charged with the responsibility to develop a plan for meeting the needs of the growing population of Americans needing care in the home and in other settings. The Commission will have 15 members appointed by the President and Congressional leaders with representation of consumers, older adults, family caregivers, and care providers.

For more on the fiscal cliff and the health care-related implications, see stories below:

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Home Care Alliance, National Organizations Make Statements on Supreme Court Decision

In light of the Supreme Court’s decision to uphold the Affordable Care Act, the Home Care Alliance of Massachusetts and other organizations representing health care providers and consumers had this to say:

“Today’s decision of the US Supreme Court has established the Affordable Care Act as the law. With their ruling, the Supreme Court has removed enormous uncertainty – particularly in states other than Massachusetts and for those involved in ACA funded demonstrations – as to whether to move forward. They now can, and we think they must.  While some parts of the law will impact Massachusetts far less directly than other states, there is evidence that our state has already benefited by some provisions. Most notably, 62,000 seniors and people with disabilities in Massachusetts have seen significant savings on their prescription drugs because the law was upheld.

All providers, including home health care, were subject to Medicare rate reductions in the ACA in order to expand coverage and pay for reform demonstrations.  These cuts have not been easy to absorb. With this ruling, we must now get to work to deliver on the promise in our state not just of universal access to insurance, but to a better coordinated, and ultimately more cost effective delivery system.”

-Patricia Kelleher, HCA Executive Director

Statement from the National Association for Home Care & Hospice (NAHC):

“NAHC has long supported reforms that increase access to health care for all in the United States and supports health delivery reforms and the expansion of Medicaid eligibility. The ACA rightly shifts the focus of care from inpatient services and institutional care to the community setting, which home health agencies and hospices have effectively served for decades.

NAHC believes that the Affordable Care Act can and should be improved. Accordingly, NAHC will continue to work with both Democrats and Republicans to improve the legislation. NAHC will ask that its implementation date be delayed for two years so that states have the time to prepare for implementation, including the creation of exchanges. This delay will also save approximately $200 billion, which can be applied to deficit reduction, extending the SGR “doc fix” and avoiding the need for any further cuts to Medicare. NAHC will continue to argue that home health care has been cut disproportionately and will oppose the imposition of copayments or additional cuts. NAHC believes that a good case can be made for expanding the scope of Medicare home health services to reduce hospitalization costs and improve services for the 5 percent of Americans who are responsible for 50 percent of total U.S. health care costs.”

-Val Halamandaris, NAHC President

Here are other statements from the following organizations:

And statements from political leaders:

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New Congressional District Maps Available

Late last year, the state’s Special Joint Committee on Redistricting approved new congressional districts for Massachusetts’s federal delegation.  Due to loss of one seat following the 2010 census, the new lines are significantly altered; this November, members will likely find themselves and their agencies in different districts and/or with different incumbent* representatives.

In order to help sort through the confusion, the Alliance created the following series of interactive, zoomable maps for its members.  Simply browse and zoom through the maps — just as you would on any other Google Map — then click on your district to bring up information about its incumbent.

Again, these maps reflect districts going into this November’s election and do not reflect current Congressional districts or representatives.  The Alliance will post a new series of maps after the election to reflect the state’s actual delegation to the 113th U.S. Congress, as elected by its citizens.

Western & Central Massachusetts (1st & 2nd Districts)

(Rep. John Olver — who currently represents NW Massachusetts — will retire in 2013 and is not shown on this map; his district is being absorbed into its neighbors).

Northeastern Massachusetts (3rd, 5th, & 6th Districts)

(Despite the familiar incumbents, the new district lines are substantially changed).

Downtown Boston & Southeastern Massachusetts (4th, 7th, 8th, & 9th Districts)

(Rep. Barney Frank is retiring from Congress, so the 4th District will have no incumbent running in November; Rep. William Keating — whose district currently includes Quincy and the South Shore — is relocating to his home on Cape Cod, where he will run in the new 9th District).


* Technically, none of the districts will have incumbents as they will all be “new.”  Regardless, all districts save the 4th are expected to have a current congressman on the ballot.

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