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Bipartisan Group Of 49 Senators To CMS: Scrap Proposed Home Health Cuts

Published by Inside CMS
Ariel Cohen
September 27, 2017

A bipartisan group of 49 senators on Tuesday (Sept 26) wrote to HHS Secretary Tom Price and CMS Administrator Seema Verma urging them not to move forward with the proposed 2018 home health payment cuts that rely on a new home health groupings model until stakeholders can fully analyze the impact of the proposed rule. The senators' letter follows a Friday (Sept 22) letter from Senate Finance Committee Chair Orrin Hatch (R-UT) that also asks the agency not to finalize the pay cuts.

The group of senators, led by Sen Marco Rubio (R-FL) and Bill Nelson (D-FL), say they have heard from a number of stakeholders that the proposed rule lacks sufficient data to allow home health agencies to estimate its cost impact.

The pay rule, proposed on July 25, would cut nearly $1 billion from Medicare reimbursement for home health services in 2019 by changing the unit of payment for home health episodes from 60 days of care to 30 days. The proposed changes would result in an estimated Medicare reimbursement cut of $950 million -- 4.3 percent -- in 2019. Regulatory pay reforms of this magnitude are usually budget neutral, but CMS had asked for comments on whether to implement the policy in a non-budget neutral manner or to use a partial budget neutrality adjustment.

"While we support efforts to increase efficiencies in Medicare, we believe this must be done in a prudent manner that does not compromise access to care for the increasing number of seniors who depend on these services to remain healthy and at home in their communities," the senators say.

They ask whether CMS plans to provide home health providers with the data used to determine the cost estimates of the proposed home health grouping model changes. The senators want to know when CMS will make that information available and, if not, what the rationale is for not providing the data.

Rather than proceeding with the proposed rule, the senators ask CMS to work with relevant stakeholders, including home health agencies and providers, and patient groups, to develop and implement new payment reforms.

Click here to see the original article on the Inside CMS website.

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