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Document Drop: HCA Seek Fixes to Medicare Payment Reform, NPP Authorizations & Continued NY Exemption from Pre-Claim Review

HCA is seeking technical corrections that would mitigate the financial and service impact of this change for providers and beneficiaries. We also urge a piloting mechanism so that the payment reforms are tested first on a demonstration basis. These and other recommendations are included in a new HCA piece being shared with Congressional offices, titled Vital Corrections, Safeguards Needed in 2018 Home Health Payment Reform Act (see https://hca-nys.org/wp-content/uploads/2018/06/Vital-Corrections-Safeguards-Needed-in-2018-Home-Health-Payment-Reform-Act.pdf).

With the reemergence of a new pre-claim review demonstration (see the June 4 edition of The Situation Report), HCA is urging Congressional oversight to make sure that the U.S. Centers for Medicare and Medicaid Services (CMS) doesn’t repeat the problems that caused CMS to halt a prior version of the demo in the first place. (CMS suspended pre-claim review in March of last year.

The demo is not proposed for New York State, but CMS has signaled it is retaining the option to extend the demo to other states beyond those currently proposed. For background, see our new piece entitled CMS Restarts Pre-Claim Review Demo without Addressing Problems That Halted It (see https://hca-nys.org/wp-content/uploads/2018/06/CMS-Restarts-Pre-Claim-Review-Demo-Without-Addressing-Problems-that-Halted-It.pdf).

HCA is also reasserting our call for passage of the “Home Health Planning Improvement Act” (H.R.1825/S.445) which is sponsored by New York Congressman Chris Collins, cosponsored by 12 of his New York Delegation colleagues as well as 177 Members of the House and 43 Senators. The bill would allow advanced-practice clinicians to order and certify Medicare home health services, not just physicians.

Earlier this year, HCA engaged six of our CHHA members in Western New York – who collectively serve 35,000 Medicare beneficiaries in Rep. Collins’ district – to write Rep. Collins urging his work to bring this measure to the floor for a vote. HCA is sharing this joint provider letter and a related new advocacy document (see https://hca-nys.org/wp-content/uploads/2018/06/Pass-Home-Health-Planning-Improvement-Act.pdf) with the entire Delegation to push hard on this commonsense bipartisan solution, as we continue to engage with Rep. Collins and the whole New York Delegation on this issue.

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