New Legislation Would Expand Access to Occupational Therapy

NAHC Report

In a promising bipartisan effort, the Medicare Home Health Accessibility Act, H.R. 7148, has been introduced by a coalition of legislators including Reps. Lloyd Smucker (R-PA-11), Dr. John Joyce (R-PA-13), Paul Tonko (D-NY-20), and Lloyd Doggett (D-TX-37). This crucial bill aims to revolutionize home health care by allowing occupational therapy (OT) to be ordered as a stand-alone service for Medicare beneficiaries.

Currently, OT services are excluded from qualifying beneficiaries for Medicare’s Part A home health benefit. This limitation means that OT services can only be provided in a beneficiary’s home if other therapy services, such as nursing, physical therapy, or speech and language pathology, are simultaneously ordered at the start of care.

Congressman Lloyd Smucker (PA-11) expressed his enthusiasm for the bill, stating, “The Medicare Home Health Accessibility Act will ensure beneficiaries can receive the care they need in a setting that more and more prefer—at home. Our commonsense measure will tailor home health orders to each patient, maximizing their ability to thrive at home and avoid costly rehospitalizations.”

Congressman John Joyce, M.D. (PA-13), emphasized the bipartisan nature of the bill, calling it a “game changer for patients who wish to heal and recover in the comfort of their homes.” He stressed the importance of in-home occupational therapy, especially in rural communities.

The proposed legislation received widespread support from Congressman Lloyd Doggett (D-TX-37), who highlighted the critical role home- and community-based care play in the healthcare system. Removing unnecessary barriers to receiving health care at home, he said, would provide more patient choices and access, particularly benefiting seniors.

Congressman Paul Tonko (D-NY-20) pointed out that passage of the bill would better target home health services to meet specific patient needs, particularly in preventing falls and accidents, ultimately enabling Medicare beneficiaries to remain independently at home.

The National Association for Home Care and Hospice (NAHC) supports this new legislation and applauds the sponsors for their leadership. With the bill’s introduction NAHC President Bill Dombi said, “It is time that Congress rectify a long-standing weakness in the home health benefit by making occupational therapy a qualifying skilled service. OT is an essential service not only for patients, it also is a proven means to saving Medicare expenditures.”

‘A Monumental Shift’: Home Health Providers Believe Review Choice Demonstration Is Here To Stay

Home Health Care News | By Patrick Filbin
 
The Centers for Medicare & Medicaid Services (CMS) has been tight-lipped about its Review Choice Demonstration (RCD) plans beyond May 2024.
 
However, industry leaders believe RCD will be extended across the country on a more permanent basis — a development that agency leaders should recognize as a momentum shifting change.
 
“We’re seeing a monumental shift in home health care and how we actually operate,” Kim Gaffey, founder and CEO of Gaffey Home Nursing and Hospice, said during a webinar Thursday. “When we started RCD five years ago, we really had three silos inside our business: clinical, billing and administrative. Oftentimes those three silos worked somewhat independently. As we entered into this RCD world, we had to bring all three silos together and examine how they interacted with each other.”
 
The Illinois-based Gaffey Home Nursing and Hospice offers home health, home nursing and hospice services.
 
Generally, RCD requires home health care providers to submit claims documentation earlier on in the care process and is meant to target and combat fraud in the industry. CMS’ goal in RCD is to reduce improper billing under Medicare’s home health benefit.
 
In 2017, lawmakers successfully blocked the expansion of the Pre-Claim Review Demonstration (PCRD) — the precursor to RCD. The original iteration got off to a rocky start in Illinois, with providers and associations complaining of administrative burden, compliance costs and high non-affirmation rates.
 
A few years later, RCD was introduced in five states: Illinois, Ohio, Texas, North Carolina and Florida. CMS suspended the demonstration in late March of 2020 due to the COVID-19 crisis, but soon after announced that it would resume in August, much to the chagrin of providers in those states.
 
A year later, CMS made a major change to the way billing was processed, which was a reprieve for providers. Today, those providers are reflecting on how those changes have affected the way they do business.
 
“One of the first things that you realize once you’re in the RCD system is how many times each one of those silos touch the document or communicate with the provider,” Gaffey said. “From the first day of patient interaction to the final day of billing, we’re seeing that we are now a team instead of three independent departments. Without implementing and examining that process, you’ll fail at RCD.”
 
Because a premium is put on accuracy and communication in the documentation process of RCD, there are a lot of positives that come with the time consuming aspects of the program…

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Medicare Program; Request for Information on Medicare Advantage Data

CMS

This request for information (RFI) seeks input from the public regarding various aspects of Medicare Advantage (MA) data. Responses to this RFI may be used to inform general efforts to strengthen Centers for Medicare & Medicaid Services’ (CMS’) MA data capabilities and guide policymaking.

To be assured consideration, comments must be received at one of the addresses provided below, by May 29, 2024.

CLICK HERE to learn more or to comment

Elon Musk Says the First Human has Received an Implant from Neuralink, but Other Details are Scant

MedicalXpress | By WYATTE GRANTHAM-PHILIPS and LAURA UNGAR

According to Elon Musk, the first human received an implant from his computer-brain interface company Neuralink over the weekend.

In a Monday post on X, the platform formerly known as Twitter, Musk said that the patient received the implant the day prior and was "recovering well." He added that "initial results show promising neuron spike detection."

The billionaire, who co-founded Neuralink, did not provide additional details about the patient. When Neuralink announced in September that it would begin recruiting people, the company said it was searching for individuals with quadriplegia due to cervical spinal cord injury or amyotrophic lateral sclerosis, commonly known as ALS or Lou Gehrig's Disease.

Neuralink is one of many groups working on linking the nervous system to computers, efforts aimed at helping treat brain disorders, overcoming brain injuries and other applications. There are more than 40 brain computer interface trials underway, according to clinicaltrials.gov.

Neuralink reposted Musk's Monday post on X, but did not publish any additional statements acknowledging the human implant. The company did not immediately respond to The Associated Press' requests for comment Tuesday.

Neuralink previously announced that the U.S. Food and Drug Administration had approved its "investigational device exemption," which generally allows a sponsor to begin a clinical study "in patients who fit the inclusion criteria," the FDA said Tuesday. The agency pointed out that it can't confirm or disclose information about a particular study.

Neuralink's device is about the size of a large coin and is designed to be implanted in the skull, with ultra-thin wires going directly into the brain. In its September announcement, Neuralink said the wires would be surgically placed in a region of the brain that controls movement intention. The initial goal of the so-called brain computer interface is to give people the ability to control a computer cursor or keyboard using their thoughts alone.

In a separate Monday post on X, Musk said that the first Neuralink product is called "Telepathy"—which, he said, will enable users to control their phones or computers "just by thinking." He added that intial users would be those who have lost use of their limbs…

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