NAHC Comments on the Proposed Changes to the Medicare Home Health Prospective Payment System
June 28, 2013 02:48 PM
The Centers for Medicare & Medicaid Services (CMS) announced on Thursday, June 27, proposed changes to the Medicare home health prospective payment system (HHPPS) for 2014 incorporating rebasing along with changes in case mix weights. The CMS proposal would apply the full 3.5% rate cut authorized under the law. The results of such a cut would be an overall payment reduction of $290 million based on projected spending in 2014.
The CMS proposal is based on a projected 2013 differential between cost and revenue (margins) of 13.63 percent. This calculation is at severe odds with calculations by both MedPAC and National Association for Home Care & Hospice (NAHC). Using a larger database than that employed by CMS, NAHC estimates the 2013 margin to be between 8 and 9 percent.
NAHC is seeking clarifications and a full disclosure of CMS’ calculation data and methodology. At this point, NAHC believes that the proposal is based on an unsupportable calculation.
“The proposal places the 3.5 million Medicare beneficiaries receiving home care services at risk of losing access to care as nearly half of the providers of this vital service would be paid less than the cost of care. It is neither fair nor right and needs to be changed,” stated Val J. Halamandaris, president of NAHC.
NAHC members are encouraged to contact their lawmakers and urge them to preserve access to home health care by opposing such rate cuts.