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Urgent: Review Choice Demonstration for Home Health Services Threatens Home Care's Viability

Thursday, June 21, 2018   (0 Comments)
Posted by: Robin Childers
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URGENT ACTION NEEDED: CONTACT CONGRESS

The Review Choice Demonstration (formerly "Pre-claim Review") will inhibit beneficiary choice and access to care, increase costs to the already burdened health care system, and do nothing to support the agency’s goals to shift toward rewarding value-based care. The administrative and financial costs associated with complying with the demonstration’s requirements threaten the financial and clinical viability of home health agencies (HHAs), particularly low-volume and rural agencies. Agencies will be forced to reduce wages or eliminate positions altogether to compensate for the increase in costs required to comply with the demonstration’s requirements. Consequently, patient access to home health services will drastically decline, leading to poor clinical outcomes and diminished quality of life.

CMS continues to subject HHAs to complex and burdensome Medicare pilot programs and demonstrations. Imposing another program, the Review Choice Demonstration, will further increase the administrative and financial burdens on HHAs without addressing the home health system’s vulnerabilities. The demonstration is a duplicative process of oversight that will only add to the burdens that already plague providers. CMS should allocate its time and resources to target specific HHAs whose behavior suggests fraudulent activity, rather than penalizing agencies that have established records of compliance with existing rules and regulations.

Efforts to Date:

  • APTA and the Home Health Section are preparing formal comments to submit to CMS.
  • APTA and the Home Health Section are offering members a template comment letter to complete and submit to the agency.
  • APTA and the Home Health Section are working closely on this issue with numerous stakeholders in the home health industry.

What Congress Can Do
Please contact your members of Congress to communicate with CMS and share stakeholders’ concerns associated with the Review Choice Demonstration and its potential impact on beneficiary access to quality care. Congress should recommend that CMS postpone the Review Choice Demonstration and move forward only when the agency can ensure that beneficiary access to home health services will not be threatened.

Resources:

The deadline for comments is July 30, 2018. Please make an effort to submit comments before the deadline.


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