Sens. Susan Collins (R-Maine) and Robert Casey (D-Pa.) yesterday introduced legislation to prevent the Centers for Medicare & Medicaid Service from making further cuts to home healthcare providers' reimbursements.
The Home Health Care Access Protection Act aims to block the 11.75 percent cuts that CMS plans to implement for home healthcare programs over the next four years.
The bill is co-sponsored by Sens. Maria Cantwell (D-Wash.), Pat Roberts (R-Kan.), Jack Reed (D-R.I.) and Christopher Bond (R-Mo.).
"The Medicare home health benefit has already taken a larger hit in spending cuts over the past 10 years than any other Medicare benefit," Collins said. "In fact, home care, as a share of Medicare spending, has dropped from 8.7 percent in 1997 to only 3.2 percent today. And it's projected to decline to just 2.6 percent of Medicare spending in 2015,” she said.
The National Association For Home Care and Hospice, in staunch opposition to the cuts, has launched a grassroots campaign urging members of Congress to take action.
Val J. Halamandaris, president of the NAHC, said, "While the need for home care is increasing, the Centers for Medicare & Medicaid Services have sought to decrease rather than increase Medicare home health funding. CMS has scheduled a $6 billion cut on Medicare home health beneficiaries who are, by definition, ill and homebound and cannot fight for themselves," she said. "Such cuts are unconscionable and out of touch with reality."
CMS contends that due to home health agencies "gaming the system" by making claims that their patients have conditions of higher clinical severity in order to receive higher Medicare payments, there has been an increase in the average clinical assessment score of home health patients.
Home health advocates said CMS makes an unfair allegation, and that there are real clinical and policy explanations that explain these increases. They claim that incentives built into the hospital DRG system, lead to ill patients being discharged more quickly. They also state that medical and technological advances allow home health agencies to treat more serious conditions that before were never possible.
Collins said CMS has not given any details of research methods, data, and findings that could back up the reasoning behind the cuts.
She added that the new bill "(W)ill also establish a reliable and transparent process for the Department of Health & Human Services to use to justify payment rates."