NAHC March on the Capitol Seeks Relief from CMS Rebasing Rule through a Legislative Amendment and Protection from Further Cuts and Copays
December 10, 2013 09:47 AM
NAHC is encouraging all of its members to participate in a March on the Capitol, either in person or virtually, to highlight issues surrounding access to home care and hospice, including Medicare home health rebasing relief and protecting home care and hospice from further payment cuts and copays. For more information, please see NAHC Report December 5, 2013.
NAHC and the Forum of State Associations have set the March on the Capitol for December 11, 2013, to coincide with expected legislative action this week on the SGR or "Doc Fix" and next year’s budget.
NAHC seeks to secure relief from the recently issued Medicare rebased rates through a proposed legislative amendment and ensure that home care and hospice are exempted from any further cuts or copays. Those unable to attend in person are urged to participate virtually by sending messages to their elected officials asking them to:
Postpone implementation of the rebasing rule and require CMS to reconsider the rule and set payment rates that ensure access to home health care services (Letter Template Here), and
Reject any proposal to use home health (Letter Template Here) or hospice (Letter Template Here) payment cuts or copays as a means to offset the cost of fixing the Medicare physician payment formula, for deficit reduction, or other purposes.
To contact Congressional offices by phone, you may obtain contact information here. Ask the receptionist to connect you with the staffer who handles Medicare issues.
Following is a description of the proposed rebasing amendment, along with talking points in support of rebasing relief.
Where Things Stand with Respect to Rebasing:
The Centers for Medicare and Medicaid Services (CMS) released the Home Health Prospective Payment System (HHPPS) Final Rule on Friday, November 22nd. The rule is effective beginning January 1, 2014.
The Final Rule unnecessarily rebases payment rates at the maximum cut permitted under the Affordable Care Act: a cut of -3.5% per year over each of the next 4 years, totaling an unprecedented cut to Medicare home health funding of 14% by 2017.
This rule disregards appeals made by hundreds of lawmakers, dozens of stakeholders among beneficiary advocacy organizations (including AARP), and tens of thousands of seniors and caregivers.
Why Action is Needed:
CMS’s rebasing cut directly affects the 3.5 million homebound seniors and persons with permanent disabilities who use home health care annually. These vulnerable citizens are older, sicker, poorer and more likely to be a minority than the typical Medicare beneficiary.
CMS acknowledges that “approximately 43 percent” of all Medicare home health providers will be paid less than the cost of care by CY 2017.No previous Medicare rule has ever had such an impact on nearly half of a health care sector.
In reality, CMS is actually underestimating the devastating impact of these cuts on providers over the next 4 years. Based on recent cost and revenue trends, it is more realistic to expect that 72.9% of providers will be paid less than their costs by 2017. To reach its projection, CMS must assume that providers can completely absorb the 14% rate cut without any financial consequences, an assumption that is in conflict with actual experience in 2011, 2012, and 2013 when rate cuts significantly reduced Medicare margins.
Below-cost Medicare payment typically leads to home health agency closurebecause – unlike other sectors – Medicare Advantage and Medicaid pay even less than Medicare and do not offset Medicare losses.
What Action is Needed:
Congress must act now to stop this unsustainable payment cut from taking effect on January 1.Congress should:
Postpone implementation of the rate change to no earlier than January 1, 2015
Require a re-evaluation of the CMS methodology for rate rebasing taking into consideration all factors relevant to maintaining access to care
Require a report to Congress on the re-evaluation and any needs for a revised rate rebasing methodology by June 30, 2014.
To read the proposed amendment postponing CMS’ rebasing rule, please click here.