Senators Send Letter to CMS Opposing Case Mix Cuts and Value-Based Purchasing Penalties
September 28, 2015 09:06 AM
Senators Susan Collins (R-ME), Debbie Stabenow (D-MI), Pat Roberts (R-KS), and Chuck Schumer (D-NY), sent a letter on Thursday, September 24, to the Centers for Medicare & Medicaid Services (CMS) that urges CMS to withdraw their proposed case mix cuts and unsustainable value-based purchasing penalties. In addition to sending its own comments to CMS opposing these proposals, NAHC enlisted Congressional support in order to convince CMS to back off the rate cuts and revise the Value-Based Purchasing proposal.
The Senate effort follows a similar letter announced earlier this week signed by 133 members of the U.S. House of Representatives (see previous NAHC Report article here). The four bipartisan Senators who signed the letter each hold important positions in the U.S. Senate. Collins is the Chairman of the Senate Committee on Aging; Roberts, Schumer, and Stabenow all serve on the Senate Finance Committee, which has jurisdiction over Medicare and Medicaid; and Schumer is the leading candidate to become the next Senate Democratic Leader when Senator Harry Reid steps down next year.
“NAHC would like to express its gratitude to Senators Collins, Stabenow, Roberts and Schumer,for signing this letter in support of home health services for Medicare beneficiaries,” said Val J. Halamandaris. “Like the House letter sent last week, this letter sends a strong message that CMS should withdraw their proposed case mix cuts and unsustainable value-based purchasing penalties. These additional payment modifications would be devastating for home health agencies, particularly small and rural providers, and would endanger Medicare patients’ ability to receive the care they need in their homes. The support from these Senators helps NAHC and its members deliver the message to CMS that they should withdraw or modify these additional proposed punitive cuts.”
In June, CMS issued the Home Health Prospective Payment System (HHPPS) proposed rule for 2016. Two concerning elements of the rule are the 1.72 percent "case mix" cut in 2016 and again in 2017, and the application of a 5-8% range in penalties and incentive payments for the proposed Home Health Value-Based Purchasing (HHVBP) pilot program. The draft HHPPS rule's proposed case-mix cut and the impact of the HHVBP pilot could exacerbate the weakened fiscal environment in which home health providers are already working, impacting the care upon which some of the most vulnerable Medicare beneficiaries depend.
The letter from the Senators urges CMS to “reconsider these two provisions in the proposed rule” in order to “ensure that the millions of Americans who rely on home health services maintain access to these critical services.”
CMS must consider the NAHC comments and Congressional comments along with any others submitted in developing the final rule. That final rule is expected to be released in late October or early November as it must be issued at least 60 days prior to its January 1, 2016, effective date.
A copy of the letter from the Senators is available here.