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New Legislation to Prevent Home Health Medicare Cuts – Action Needed!

The Preserving Access to Home Health Act was introduced both in the Senate and the House last week. The Senate bill (S.4605), led by Senators Debbie Stabenow and Susan Collins, would freeze the current payment rate in place, with the exception of annual market basket updates, through 2025. The House bill, which was introduced by Reps. Terri Sewell (D-AL) and Vern Buchanan (R-FL), is identical to the one introduced in the Senate. 

Please urge our Senators and Representatives to sign onto the Act. Calls and personal messages are best, but for those short on time a message has been pre-drafted and is ready to go in the NAHC Virtual Advocacy Center.

MEDICARE PAYMENT CUTS THREATEN THE HOME HEALTHCARE SYSTEM – VALUED BY AMERICA’S SENIORS AND PEOPLE WITH DISABILITIES.

HELP US FIGHT FOR THOSE WHO CANNOT FIGHT FOR THEMSELVES. 

PMHC HCBS Funding Alert

From Partnership for Medicaid Home-Based Care (PMHC)

Senate Majority Leader Chuck Schumer (D-NY) and Sen. Joe Manchin (D-WV) announced an agreement on a reconciliation package that includes tax and energy provisions in addition to drug pricing reforms and additional ACA subsidies.  As currently written, The legislation – the Inflation Reduction Act of 2022 – does not include funding for Medicaid HCBS. This is a narrowly crafted compromise approach and other things were also dropped.

Senate Democrats who have championed permanent Medicaid HCBS funding indicated to PMHC as recently as this week that the parameters of a reconciliation bill would be determined by Leader Schumer and Sen. Manchin.  It is unlikely that the Inflation Reduction Act of 2022 will be modified to include HCBS funding.  However, PMHC weighed in with Leader Schumer’s policy director in support of including Medicaid HCBS investments in the reconciliation bill.  We encourage PMHC members to use the VoterVoice grassroots campaign to urge Members of Congress to support these critical investments. 

The legislative text and summaries of the Inflation Reduction Act are available here.  The bill is expected to be considered by the Senate next week. 

CMS Announces Unprecedented Quality Measure Set for Home- and Community-Based Services

Home Health Care News | By Andrew Donlan

The Centers for Medicare & Medicaid Services (CMS) released its first ever home- and community-based services (HCBS) quality measures Thursday.

The agency said the measures will promote “consistent quality measurement within and across state Medicaid HCBS programs” and are a “critical step to promoting health equity among the millions of older adults and people with disabilities who need LTSS.”

The measures are built around three pillars: access, a rebalancing of HCBS spend versus institutional care spend and community integration. For now, the measures are voluntary – with one caveat. 

“While use of this measure set is voluntary at this time, CMS plans to incorporate use of the measure set into the reporting requirements for specific authorities and programs, including the Money Follows the Person (MFP) program and future section 1115 demonstrations that include HCBS,” a state Medicaid director letter read.

The MFP program is a CMS-directed way to get individuals out of institutional-based care and back into their homes and communities to receive HCBS. As recently as March, CMS put forward $110 million to boost MFP, and therefore HCBS services, across the country.

In other words, following the measure set is strongly encouraged for states.

“CMS is using every lever available to protect and expand coverage for all people eligible for Medicaid,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “We are working to expand their access to care across settings – including in the setting of their choice.”

While the home health industry is highly – and very consistently – regulated across the country, the personal home care industry has not been historically.

Strictly private-pay providers will still not be affected necessarily by the CMS quality measure set, but it is a sizable step to industry standardization, particularly among Medicaid-focused, HCBS providers.

“Today’s announcement provides states with tools to better understand and compare health outcomes across groups receiving home- and community-based services,” Brooks-LaSure continued. “The use of consistent quality measures across the country is another step toward reducing health disparities and ensuring that people with disabilities, and older adults enrolled in Medicaid, have access to and receive high-quality services in the community.”

The measures are aiming to obtain the aforementioned three goals:

• Increased access, defined as beneficiary and caregiver awareness of resources that support overall well being and HCBS.

• A rebalancing, which is aimed at finding a more equitable balance between spending on institutional care and HCBS care in communities

• Community integration, which is focused on “ensuring the self-determination, independence, empowerment and full inclusion” of children, adults and older adults in the Medicaid program receiving HCBS 

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