Home Health and the Return of Congress
September 8, 2017 02:41 PM
The United States Congress returned Tuesday, September 5, to a grueling agenda of must-do items and a deepening discord on both ends of Pennsylvania Avenue that threatens the ambitious Republican agenda to repeal and replace the Affordable Care Act and overhaul the tax code.
One box was apparently checked yesterday, when President Donald Trump surprised his Republican colleagues by agreeing with Senate and House Minority Leaders Chuck Schumer (D-NY) and Nancy Pelosi (D-CA) on a short-term debt ceiling increase tied to relief for victims of devastation caused by Hurricane Harvey. Preventing a government shutdown after September 30 is still on the to-do list.
Senate Republicans have been relying on a fast-track budget measure known as reconciliation in their effort to repeal Obamacare, which stalled weeks ago thanks to a decisive vote by Sen. John McCain (R-AZ). The parliamentarian, Elizabeth MacDonough, ruled that the budget measure expires at the end of the month when fiscal 2017 ends, meaning any repeal effort beyond that date would need 60 votes to overcome a Democratic filibuster. In other words, if repeal and replace is going to happen, it must happen before the end of September.
President Trump — who has repeatedly predicted Obamacare is about to implode — has called for another repeal vote in the Senate, as have GOP conservative hard-liners in both the House and Senate. The Senate HELP committee is set to hold hearings on how to stabilize Obamacare.
Congress is expected to vote on a $7.85-billion disaster aid package for victims of Hurricane Harvey, understood by everyone to be a mere down payment on what ultimately could be a $150-billion tab for the flooding across southern Texas and Louisiana.
When it comes to home health, a new problem has arisen – the Medicare payment rule recently proposed by the Centers for Medicare and Medicaid Services (CMS). The proposed payment rule, set to take effect in 2019, is a significant and untested proposal that will cause widespread disruption to the entire home health industry. According to CMS’s own estimates, the proposed rule will result in a cut over nearly $1 billion annually -- approximately five percent of annual Medicare spending on home health. Simply put, if implemented, this could be a devastating payment model. NAHC will make it Job One to convince CMS to withdraw this proposal and work with stakeholder groups to ensure that a new model is developed and implemented thoughtfully, without hindering access to care.
While the proposed Medicare payment rule will be our number one priority, we will continue to advocate for our other priority legislative issues. For home care, those issues include the Home Health Documentation and Program Improvement Act (resolves the face to face/physician certification documentation issue), the Home Health Care Planning Improvement Act (allows non-physician providers to order home health services), and the Preserve Access to Medicare Rural Home Health Services Act (rural add-on). While nothing is firmed up, we do feel optimistic about the chances of the Rural add-on being included in a larger package of programs that expire this year and will need to be extended.
For Hospice we will continue to pursue the Palliative Care and Hospice Education and Training Act (PCHETA), and the Patient Choice and Quality Care Act (PCQC). We’ve received positive signals that the House of Representatives Energy and Commerce committee is favorable to this measure and will likely soon be holding a mark up session for it.
Stay tuned to NAHC Report for developments on all of these priorities.