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Act Now on Home Health Rural Add-on, NPP Authorization of Home Care

The national push for extension of the home health rural add-on continues, as Congress considers extension bills and other fiscal matters amid the ongoing debate over the continuing budget resolution.

In a separate but important federal matter, HCA has also learned that key leaders are considering a priority bill for authorization of home care services as part of an omnibus package. The bill is sponsored by Buffalo-area Congressman Chris Collins and has strong support from New York’s Congressional Delegation who we need to press Congressional leaders for final adoption of this measure. 

HCA asks members to act on both issue areas today. Details are below.

Rural Add-on Update and Action Item

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While the home health rural add-on is in play, the proposal being considered at present in the U.S. Senate is extremely limited, and we need to push hard to change this.

The current Senate proposal would increase the add-on to 4% in so-called “frontier counties,” which, we believe, may not include any (or very few) areas of rural New York. This frontier-designated add-on would get reduced a percentage-point each year to 0% by 2023. Other rural areas, meanwhile, would get a 3% add-on that is similarly phased out to 0% by 2021.

A straight and permanent 3% rural add-on, as HCA and our partners at NAHC have been urging, would continue funding to rural providers in New York State who rely on this resource at a time when 69% percent of these agencies report negative operating margins.

Providers in rural regions know the reasons for these financial outcomes: rural delivery of home health services is significantly more costly because of the extra travel time to cover long distances between patients, higher transportation expenses, and other factors unique to rural service delivery. Home health agencies in rural areas are often smaller in size, with fixed costs that must be spread over fewer patients and fewer visits.

New York Senator Charles Schumer, the Senate’s Minority Leader, has gained important leverage in negotiations over the continuing budget resolution and other fiscal matters that require super-majorities in the closely divided Senate. Please take a minute on HCA’s Legislative Action Center to write Senator Schumer and the rest of the Congressional Delegation urging a straight 3% extension of the rural add-on in place of the limited plan now under consideration.

NPP-Authorization Bill Gains Traction: Support Needed in Omnibus Plan

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As noted above, Buffalo-area Congressman Chris Collins is sponsoring a bill (H.R. 1825) that has long been a priority of HCA’s: allowing nurse practitioners, physician assistants, clinical nurse specialists and other non-physician advance-practice professionals to order and certify Medicare home health services. HCA members have responded strongly to our action alerts in the past for similar versions of this bill and we ask you to take a few minutes again to use our Legislative Action Center in support of this latest measure as part of an omnibus bill or Medicare package.

Important: Our Legislative Action Center allows you to customize your message. If you are a provider in the Buffalo region represented by Chris Collins, please tailor your message to Rep. Collins, thanking him for his sponsorship and urging his action to gather support of H.R. 1825 from House Speaker Paul Ryan and other House leaders.

If you need any assistance with this customization, please do not hesitate to write back HCA’s Communications Director Roger Noyes at or call him at (518) 810-0665.