Recently, a crucial bipartisan act was introduced by Senators Debbie Stabenow and Susan Collins, which significantly impacts the well-being of Home Health Agencies. The vital legislation in question is the Preserving Access to Home Health Act of 2023. It is essential for you to take part in reaching out to your representatives to guarantee complete support for the passage of this act.  

The Preserving Access to Home Health Act of 2023 has been specifically crafted to request two vital actions from Congress. First, it seeks the removal of the requirement for CMS to make adjustments, such as behavioral adjustments, when a payment system undergoes changes. In the case of home health, there was a mandate for a behavioral adjustment when the system transitioned from the Prospective Payment System (PPS) to the PDGM model. This adjustment was made to account for the anticipated behavioral changes that would affect reimbursement rates once the PDGM model was implemented.  

We have never agreed with the methodology employed in calculating this adjustment, and despite CMS being directed to maintain complete transparency regarding this calculation, sufficient detailed information has not been provided. As a result, it remains unclear how the precise calculation or data source led to the current 7.85% reduction that they are presenting. 

As it stands, half of the 7.85% reduction has already been applied to your rates, impacting you in 2023. The aim of this act is not only to eliminate the requirement for CMS to make the adjustment but also to retroactively apply it as though it was part of the 2018 legislation where the requirement first emerged.  

The second crucial aspect of this act is the request for MedPAC to include all payer information, not just traditional Medicare, in their annual report on Medicare Home health profits for Home Health agencies. Those involved in home health are aware that over 50% of patients are transitioning to Medicare Advantage Plans instead of traditional Medicare. It is unreasonable to base information provided to Congress solely on traditional Medicare profits when Medicare Advantage is also funded by the Medicare program. Hence, this act would mandate MedPAC to report the profitability of home health agencies based on all payers, which would naturally encompass Medicaid patients too.  

Passing this legislation is crucial for the home health industry. We are anticipating the release of the 2024 Proposed Rule, which will affect the home health rates for 2024. If this act is not enforced, we face a considerable risk of experiencing further reductions in reimbursement.  

Below is a link to the National Association for Home Care & Hospice advocacy site, where you can enter your name, address, and phone number. Based on your address, the site will identify your Congressional representatives and allow you to send them a message directly from your email address with just a click of a button. Advocacy has never been easier, and it’s crucial that they hear your voice. To access this site, click here 

If you require further information regarding this advocacy request, please feel free to contact Healthcare Provider Solutions, the National Association for Home Care & Hospice, or your State Association.  

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