Bipartisan legislation introduced just days ahead of the 2023 Home Health Prospective Payment proposed rule seeks to repeal payment cuts under PDGM and to reframe how MedPAC analyzes agency revenues.
 
The Preserving Access to Home Health Act of 2023 is “essential legislation,” says Bill Dombi, president of National Association for Home Care & Hospice (NAHC).
 
“Current policy positions of CMS put access to home health services for the over 3 million beneficiaries that utilize this care in jeopardy,” Dombi says.
 
The bill was introduced June 22 by Sens. Susan Collins, R-Maine, and Debbie Stabenow, D-Mich. The 2024 proposed rule is expected to be released around July 1.
 
CMS had already suggested that the 2024 rule would include a 3.925% permanent payment cut, along with the potential for some portion of more than $3 billion in temporary cuts to account for what CMS considers overpayments during the first three years of PDGM.
 
If signed into law, the bill would:
  • Repeal permanent and temporary payment adjustments. It would eliminate the requirement that CMS make payment cuts related to behavioral changes under PDGM, including the 3.925% cut made in 2023’s payments.
  • Instruct MedPAC to analyze home health payments. The bill instructs MedPAC to review aggregate trends under Medicare Advantage (MA), Medicaid and other payers, and consider the impact of all payers on access to care for Medicare home health beneficiaries. This would include data on visit utilization and total payments by program.
The industry has challenged revenue projections attributed to home health providers, noting that the results have been limited to traditional Medicare and doesn’t incorporate underpayments from MA plans and Medicaid. — Greg Hambrick (ghambrick@decisionhealth.com)