LEGISLATION | OCTOBER 11, 2017 | BY PETER NOTARSTEFANO
LeadingAge thanks Rep. Kristi Noem (SD-R) for introducing the Rural Home Health Extension and Regulatory Relief Act (HR 3992) that would delay implementation of the Home Health Groupings Model (HHGM) until 2020. The HHGM would drastically change the way home health agencies are reimbursed through Medicare, including by changing the standard episode of care from 60 days to 30 days. The Centers for Medicare & Medicaid Services (CMS) estimated that HHGM would reduce Medicare payments to home health agencies by $480 million to $950 million in calendar year 2019. In our comment letter on the FY2018 HH Proposed Rule , we requested CMS delay any implementation of the Home Health Groupings Model. The delay would give CMS time to meet with stakeholders to improve the proposed HHGM, as well as reconsider their proposal to not have a budget neutral payment. There are some sections of the home health groupings model that have promise, such as the emphasis on wound care, medication management, teaching and assessment, and the attempt to incorporate a wider variety of costs to determine weights. The reduction of payments for therapy and behavioral health in the HHGM would have a devastating impact on access to home health services for frail older adults. More work needs to be done before the HHGM is implemented.
We also would like to thank Rep. Noem for including an extension to the rural add on for rural home health agencies in the bill. We have numerous not for profit home health provider members in rural/frontier areas that depend on the extra payment to remain financially viable. The high cost of transportation and case coordination in rural areas are major challenges that are not covered under the current payment system.
The bill was referred to the House Ways and Means Committee and Energy and Commerce Committee for consideration. We urge members to reach out to their Representatives in the U.S. House of Representatives to support this legislation.