As Congress wraps up for the year, the Partnership is again calling on Congress to enact the Pre-Claim Undermines Seniorsâ€™ Health (PUSH) Act of 2016, which would delay the implementation of the home health pre-claim review demonstration until Medicare and home health agencies are prepared to manage the process without disrupting care delivery.
Since the program was first rolled out in Illinois this summer, providers across the state have run into numerous delays and technical problems â€“ including improper care denials and issues using the Medicare Administrative Coordinators (MAC) electronic submission system. This led to longer wait times and unnecessary delays in patient services.
The PUSH Act, orginially introduced by Reps. Tom Price, MD (R-GA) and Jim McGovern (D-MA), would delay pre-claim review for one year to allow Congress, CMS, Â and home health stakeholders to figure out how to strengthen the program through proper education and training. You can find out more about the bill here.
Fortunately, pre-claim review has already been temporarily suspended in several other states where it was slated to roll out. The PUSH Act would delay the pre-claim review for the rest of the country, and stop the program underway in Illinois.
The bill also calls on the Centers for Medicare & Medicaid Services to analyze the impact of the program and present a series of alternative measures for combating home health claims fraud â€“ the original purpose of pre-claim review.
There is still time for you to help protect vulnerable seniors who depend on home health seniors – contact your member of Congress today and asking him or her to support this bill!Â Click below to get started: