MedPAC Issues its Report to Congress
Recommendations include a per episode home health copayment, elimination of market basket updates and program integrity measures for home health services; elimination of the update of hospice payment rates and changes to the Medicare payment syst
March 21, 2014 08:47 AM
The Medicare Payment Advisory Commission (MedPAC) recently issued its annual Report to Congress, which it is required to do by law. The report makes recommendations on payment policies for traditional fee-for-service Medicare (Parts A and B), as well as Medicare Advantage plans (Part C) and prescription drug plans (Part D).
Below are the key recommendations for home care and hospice services that were included in MedPAC’s report:
Home Health Agencies
The Congress should direct the Secretary to reduce payments to home health agencies with relatively high risk-adjusted rates of hospital readmission.
The Secretary, with the Office of the Inspector General, should conduct medical review activities in counties that have aberrant home health utilization. The Secretary should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud. (First recommended in March 2011).
The Congress should direct the Secretary to begin a two-year rebasing of home health rates in 2013 and eliminate the market basket update for 2012. (First recommended in March 2011).
The Secretary should revise the home health case-mix system to rely on patient characteristics to set payment for therapy and nontherapy services and should no longer use the number of therapy visits as a payment factor. (First recommended in March 2011).
The Congress should direct the Secretary to establish a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use. (First recommended in March 2011).
The Congress should include the Medicare hospice benefit in the Medicare Advantage benefits package beginning in 2016
The Congress should eliminate the update to the hospice payment rates for fiscal year 2015.
MedPAC also reprinted its previous recommendations related to hospice payment reform and oversight:
The Congress should direct the Secretary to change the Medicare payment system for hospice to:
Have relatively higher payments per day at the beginning of the episode and relatively lower payments per day as the length of the episode increases,
Include a relatively higher payment for the costs associated with patient death at the end of the episode, and
Implement the payment system changes in 2013, with a brief transitional period.
These payment system changes should be implemented in a budget neutral manner in the first year. (First recommended in March 2009).
Given that MedPAC has once again recommended additional copayments and payment cuts for vital home care and hospice services, NAHC is encouraging all its members to attend this year’s March on Washington – March 23 – 26 – to please the home care and hospice community’s case directly to lawmakers.
For more on MedPAC’s recent recommendations, please see NAHC Report from January 21, 2014; another article from January 21, 2014; January 29, 2014.
To register to attend the March on Washington, please click here.
To review MedPAC’s Report to Congress Fact Sheet, please click here.