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Legislation Introduced in Congress to Safeguard Access to Medicare Home Health Services

Legislation Introduced in Congress to Safeguard Access to Medicare Home Health Services

Medicare Government Affairs & Advocacy

The Preserving Access to Home Health Act of 2023 (S.2137) was recently reintroduced in the U.S. Senate to address concerns regarding Medicare home health payments. This legislation aims to prevent further cuts to Medicare home health payments in 2024 and beyond and restrict the Centers for Medicare & Medicaid Services (CMS) from making certain payment-rate adjustments. If passed, the bill would also require the Medicare Payment Advisory Commission (MedPAC) to consider Medicare Advantage payment rates in its annual reports to Congress.

In 2020, CMS implemented the Patient-Driven Groupings Model (PDGM) as a new payment system for Medicare home health. However, CMS's interpretation of its budget neutrality mandate has resulted in significant payment reductions, resetting base payment rates to unsustainable levels. The bill seeks to limit CMS's ability to continue making reductions to the payment rate.

Despite high inflation, home health providers experienced a minimal 0.7% payment increase in 2023. CMS is seeking a -7.85% adjustment to home health payments, with the first half (-3.925% reduction) already implemented this year. Providers anticipate the second half of the cut to be included in the 2024 home health payment rate proposal, set to be released later this summer.

The National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare stress the urgent need for the Preserving Access to Home Health Act to safeguard the Medicare home health program, which serves approximately 3.2 million older Americans annually. They highlight key considerations for lawmakers, including the projected drop in Medicare home health spending according to the Congressional Budget Office (CBO), the preference of 94% of Medicare beneficiaries for post-hospital care at home, and the cost savings to the Medicare Trust Fund achieved through home health services.

Access to home health is crucial for efficient care transitions and aligns with patient preferences. However, the increasing rejection rate of home health referrals has led to longer hospital stays and challenges transitioning patients from hospitals to their homes.

Please make your voice heard by urging your Senators to support S.2137! To take action on the HCAF Legislative Action Center, please click here.

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