HCA joined with state home care associations across the country over the weekend to discuss some of the most dominating issues in the field. The meeting included association executives, executive and policy representatives of the National Association for Home Care and Hospice (NAHC), and members of the NAHC Board of Directors.
NAHC President and CEO, Bill Dombi, led discussions on subject areas that included:
- The effort to turn back the Centers for Medicare and Medicaid Services (CMS) proposed massive cuts Medicare home health payments.
- Advocacy by NAHC and by the state home care associations is continuing. At a meeting on Friday, October 21 between CMS and NAHC where the issues with the proposed cuts were again discussed, CMS reportedly provided no insights as to its intended action in the reconsideration of the cuts. In the meantime, Congressional Leaders including Senate Majority Leader Charles Schumer and House Speaker Nancy Pelosi have both weighted in directly with the Administration expressing concern with CMS’s proposal. Also, HCA, NAHC and state associations across the US continue to petition all Members of Congress to co-sponsor the “Patient Access to Home Health Act,” S.4605/H.R.8581, that would halt such cuts through 2025 if CMS proceeds to adopt the 2023 Medicare Home Health Payment Rule with the cuts as proposed. The CMS Final Rule is anticipated to be issued within the next week, and thus every effort must continue to be waged to urge CMS to abandon these cuts. Every HCA member should continue to follow the grassroots advocacy guidance here. HCA thanks agencies and individual staff who follow-up, and we urge everyone who has yet to participate, to please do so today, and those have already reached out, to please continue in this final push!
- Home Care Workforce initiatives.
- NAHC is pursuing a multitiered process, together with a consultant and a series of working committees to address elements central to home care workforce recruitment, training and retention. A major part of this effort that was reviewed by Mr. Dombi is working to further build the strong “public image” of home care, what does, what it means for individuals needing the care, what it means to the health system, what it means to those working in the field. HCA President Al Cardillo described HCA’s and related NYS initiatives to address the health workforce need. He cited HCA’s statewide collaboration workforce summit and our summary report (https://hcanys.memberclicks.net/assets/site/Final%20Update%20-%20Workforce%20Summit%20Summary.pdf) and an array of HCA program initiatives both direct and collaboration with association partners.
- NAHC-sponsored studies on home care and hospice partnerships with Medicare Advantage Plans and on hospice benefit.
- Reports on these studies are both anticipated by the end of the year, and expected to render important data and perspectives to assist the field in the related goals of working in conjunction with Medicare Advantage Plans – which are serving a growing proportion of Medicare beneficiaries, including expansion to incorporate hospice under the Value Based Insurance Design(VBID) model, testing the hospice benefit under VBID.
- A proposed US Department of Labor rule on classification of “employees” versus “independent contractors.” (This issue is also discussed in the October 17 edition of the Situation Report, https://hca-nys.org/rule-proposed-on-employee-or-independent-contractor-classification/) The proposed rule has been filed with a 45 day comment period (now midway) and HCA will be working with NAHC and others on the analysis and implications for the field.
- A class action complaint filed against the US Department of Health and Human Services seeking Medicare beneficiary access to home health aide coverage under the Medicare home health benefit.
- On October 11, the Center for Medicare Advocacy filed a lawsuit representing Medicare beneficiaries who rely on home health aide services, in the complaint entitled Johnson v. Becerra, No. 1:22-cv-03024. The Plaintiffs claim that the HHS Secretary has “adopted policies and practices that impede and restrict the availability and accessibility of Medicare-covered home health aide services for eligible beneficiaries with chronic, disabling conditions.” They state that “the Secretary has effectively redefined eligibility for Medicare-covered home health aide services to exclude people who require more than very minimal aide services for a short duration of time.” Dombi and the Forum participants discussed the case and the implications at length, and considerations for how the industry might participate.
Members of the NAHC policy and regulatory team led discussions on the future of hospice and palliative care policy and delivery, MedPAC issues, and a package hospice and palliative care legislative initiatives in the Congress. HCA will providing additional information on these hospice developments at our November 2 HCA Hospice Forum meeting. All HCA hospice member leaders and staffs are invited to join in this discussion, as it also coincides with National Home Care and Hospice Month. Hospices should register for the Forum at: https://us02web.zoom.us/meeting/register/tZAqcOippzguHNIw-Y7YYDK-B33pKm2QS3g9
Hospices should register for the Forum here.