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Reps. Ask CMS to Examine Medicare Home Health Cuts

Published by Law 360
September 26, 2013

More than 140 lawmakers from the U.S. House of Representatives asked the Centers for Medicare and Medicaid Services on Wednesday to take a closer look at the agency's proposed cuts to Medicare home health benefits under the Affordable Care Act.

The representatives urged CMS administrator Marilyn Tavenner to reconsider the proposed Medicare home health funding cuts of roughly 14 percent over four years, saying it caused them "deep concern" that it would cut off access to such services that seniors, particularly those in underserved areas, would need, according to a letter they sent her Wednesday.

The cuts would total some $22 billion over the next 10 years, according to a statement by industry group Partnership for Quality Home Healthcare.

"Home health is a critical service that allows patients to be treated in a cost-effective manner in the environment they prefer — their home," the lawmakers said in the letter to Tavenner. "Home health patients are among the most vulnerable in the Medicare program, being older, sicker and poorer than the general Medicare population. As a result, access to home health care services is essential, as it enables vulnerable seniors to receive the medical treatment they need in the cost-effective setting they prefer most."

The lawmakers argued also that the proposed cuts do not sufficiently account for declining revenues to home health care agencies due to cuts including sequestration, nor for their considerably higher operating costs, according to their letter. If the proposal proceeds in its current form, Medicare reimbursement will sink below costs in all states, they argued.

Home health care providers lauded the lawmaker's move Thursday, saying the cuts would harm the small home health agencies and nonprofits in the country and that Medicare payments for home health care have already been cut by $72.5 billion since 2009, according to the Partnership for Quality Home Healthcare.

“We applaud Representatives Doris Matsui [D-Calif.] and David McKinley [R-W.Va.] for their leadership on this important senior care issue and thank their 140 House colleagues for taking action to protect seniors’ access to vital home health services,” the group's CEO Eric Berger said in the statement.

“We look forward to a more comprehensive analysis of the proposed rule so that homebound Medicare beneficiaries can continue to access the cost-effective and clinical advanced health care services they need in the setting they prefer,” he said.

Some 3.5 million seniors depend on Medicare home health benefits, which include skilled nursing care, physical therapy, occupational therapy, speech therapy and other services provided at home, according to the group.

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