On Sunday, March 21st the US House of Representatives passed historic Health Care Reform Legislation. A friend from Maryland shared the following information related to the House of Representatives’ latest adaptations (that impact home health gathered from a phone conference with Bill Dombi of NAHC. These are changes the House is putting into the Senate bill. Please note that the remainder of the Senate bill is unchanged, including Medicare HH cuts, hospice cuts, Medicaid home care improvements, and the CLASS Act.
These changes include additional cuts to hospitals, Medicare advantage, DME, outpatient services, and imaging services. There are no increased cuts to home health or hospice.
The Senate bill has far less cuts than the House bill. Also the cuts that are in the Bill will come in much later than the original House version or that of the Obama administration, giving time for agencies to adapt or home health advocates time to repeal or change the legislation. There would be no cuts in the 2010 home care payment rates. There may also be a rural add-on of 3% April 1, 2010. Also included:
1. The Nebraska “special deal” is out.
2. Chronic Care Management is still in. (That may have a bright future.)
3. Emphasis on fraud and abuse is still in
4. Super MedPAC is still in. However, more powers are being reserved for Congress.
5. Post Acute bundling is still in as a pilot project.
At last count 204 Democrats will vote yes. 12 more are needed. The latest estimate is that there is a 49% to 50% chance the bill will pass.
The 36 month Rule- If a home care agency has enrolled in Medicare or changed 5% of their ownership in the last 36 months, they will lose their ability to bill Medicare if they change their ownership again. If a deal was done and a Form 855 was properly filed before January 1, 2010, the agency is exempted from this rule.
If any home health agency has had ANY improper coverage determinations recently– homebound,etc. please contact HCLA immediately. The national association is forming a group appeal.
The MedPAC Report to Congress (Available at MedPAC.gov.) Bill Dombi indicates this shows why MedPAC is hostile to home care. The report speaks of alleged therapy misuse, continues to speak of case mix creep, a rapid increase in the number of agencies, and more. MedPAC recommended co-pays for home care. That is not likely to happen in 2010. However, they will keep proposing it in 2011 and beyond. Every agency needs to stay involved politically. There are major threats and opportunities that are constantly facing us.
Who will be the first Louisiana agency to sign on to visit Washington, DC this April 12th and 13th? As of Friday morning, March 19, 2010, I have gotten no response to the request to have someone join HCLA on Capitol Hill. I’ll be reporting the numbers I get every few days until April 9th. Would you please join HCLA’s contingent on Capitol Hill on Lobby Day?
