142 Members of Congress Urge CMS to Analyze Proposed Medicare Home Health Rebasing Cuts

WASHINGTON (Sept. 26, 2013)—The Partnership for Quality Home Healthcare—a coalition of home health providers dedicated to improving the program integrity, quality and efficiency of home health care for our nation’s seniors—applauded 142 Members of the U.S. House of Representatives for expressing their deep concern with proposed Medicare home health funding cuts of 14 percent in a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner.

In June, CMS proposed to rebase Medicare home health payments at a rate of 3.5 percent over the next four years. If implemented in its current form, these cuts will result in a 14 percent overall reduction to Medicare home health payments, which would reduce the national average Medicare margin to -9.77 percent and cause 47 out of 50 states and the District of Columbia to have negative Medicare margins by 2017. The proposed cuts total nearly $22 billion over 10 years.

In a letter to CMS, the bipartisan lawmakers write, “We are concerned that the proposed rule would have a direct impact on access for millions of seniors, many of whom reside in rural and underserved communities. A significant amount of this care in rural and underserved areas is provided by thousands of small businesses that would be most at risk of going out of business under the proposed rule.”

Lawmakers and home health leaders are deeply concerned that the proposed 2014 Home Health Prospective Payment System (HHPPS) rule is not based on a detailed analysis, as required in the Affordable Care Act (ACA). The proposed rule also fails to include a complete analysis of its impact over all four years over which it will be implemented (2014-2017) or of its impact on small businesses, as required by the Regulatory Flexibility Act.

The lawmakers continue, “As a result of these factors, we respectfully request the Agency’s analysis of the impact of this rule on beneficiaries, the national delivery system, each state and small businesses be performed in each of the four years in which the rebasing adjustment is to take effect. We also ask that CMS utilize a more current and complete data set to fully account for the operating costs that are routinely borne by home health providers.”

“Congress and the Administration must work together to ensure that our nation’s poorest, sickest and most vulnerable seniors are able to remain in their homes and receive necessary skilled nursing and therapy services, while avoiding unnecessary hospitalizations,” stated Congresswoman Doris Matsui (D-CA). “To ensure patient access is not strained, we are asking CMS to fully assess the impact of its proposed rule on the delivery of home health care.”

“Medicare payments need to be fair and accurate to protect homebound senior citizens and disabled Americans’ access to the home health care they need.  We simply cannot expect providers—particularly small agencies—to maintain current operations if Medicare payments fall below the cost of care,” added Congressman David McKinley (R-WV). “We are therefore urging the Administration to take a closer look at this proposal to ensure beneficiary access and small businesses are not jeopardized.”

“We applaud Representatives Doris Matsui and David McKinley 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,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “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—their homes.”

Earlier this month, the U.S. Small Business Administration expressed similar concerns to CMS that the proposed rule underestimates the impact the rebasing cuts will have on the nation’s small home health agencies, including small businesses and nonprofit organizations. Likewise, AARP, the American Hospital Association and dozens of other organizations representing physicians, nurses, therapists, caregivers, veterans, senior and patient advocates have voiced concern for the proposed payment cuts to Medicare home health services.

A survey of more than 4,500 registered voters ages 65 and older completed last month found that nearly nine in 10 American seniors oppose more cuts to Medicare payments for home health care, which have already been cut by $72.5 billion since 2009. Similarly, an overwhelming majority of American seniors call on the Administration and Congress to take action to prevent such cuts. The survey was conducted by Public Policy Polling for Bring The Vote Home, a home health community initiative to enable homebound seniors and disabled Americans to participate in the democratic process by assisting them to register to vote and apply for absentee ballots.

Medicare home health is defined as medical care provided in a patient’s home and can include skilled nursing care, physical therapy, occupational therapy and speech therapy. Today, approximately 3.5 million American seniors rely on the Medicare home health benefit for care.  According to AARP, nine out of every 10 seniors would prefer to age at home rather than a nursing home or other care facility. To learn more, visit homehealth4america.org.