Members,
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Introduction of Choose Home Care Act
Senators Debbie Stabenow (D-MI) and Todd Young (R-IN) have officially introduced the Choose Home Care Act of 2021 (S.2562), which would create an add-on to the existing Medicare home health benefit allowing certain Medicare patients to receive post-hospital services in their homes. The new benefit would be available for those eligible for both skilled nursing facility
(SNF) and home health agency care, and include a 30-day unit of service combining today’s Medicare Home Health Benefit with additional supportive care services, such as Personal care; Non-emergent transportation; Nutritious meals; Additional remote patient monitoring; and Adaptive equipment for the home. An outside health care economics firm, Dobson DaVanzo, has estimated the Choose Home program could generate Medicare savings of $144-247 million per year (approximately 6.5-11.1% of SNF 1st PAC payments), with $1.6-2.8 billion in savings over 10 years, in SNF care substitutions. The legislation is endorsed by the National Association for Home Care and Hospice, AARP, Partnership for Quality Home Healthcare, among others. A house companion bill is also expected to be introduced in the coming weeks.
A TAHC&H-established subcommittee reviewed the legislative text and summary documents, and shared questions and suggestions with the stakeholders involved. TAHC&H plans to meet with the bill sponsors to further discuss the legislation. TAHC&H is pleased that Congress has recognized more can be done in the home and will be advocating for its passage.
Infrastructure
On July 29, Republican and Democratic Senators negotiating a bipartisan infrastructure bill announced an agreement with the House on a $550 million “hard infrastructure” package. At this time, legislative text is still being drafted but it is expected to include health care pay-fors, such as $49 billion from delaying Medicare Part D rebate rule, $8.7 billion from the mandatory sequester, and $3 billion in savings from reducing Medicare spending on discarded medications from large, single-use drug vials. Despite no legislative text, Senate Leader Chuck Schumer (D-NY) proceeded with a procedural vote on Wednesday setting up a final vote likely late next week. In a 67-32 vote, 17 Republicans joined all 50 Senate Democrats to begin consideration of the infrastructure package.
This bill is separate from an expected Budget Resolution/Reconciliation “human infrastructure” package. House Speaker Nancy Pelosi (D-CA) has repeatedly stated that the House will not take up the bipartisan infrastructure bill until the Senate passes its reconciliation package. Leader Schumer continues to reiterate that he intends to passing two major infrastructure packages — the bipartisan infrastructure framework and a budget resolution with reconciliation instructions before the August recess. Senate Budget Chairman Sanders continues to work on a $3.5 trillion Budget Resolution, which is expected to include health care policy provisions, such as expanding Medicare to include hearing, vision and dental benefits, and funding for home and community based services (HCBS).
FY 2022 Hospice Final Rule Released
On July 29, the Centers for Medicare & Medicaid Services (CMS) released the “FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements” Final Rule.
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year 2022. This rule makes changes to the labor shares of the hospice payment rates and finalizes clarifying regulations text changes to the election statement addendum that was implemented on October 1, 2020. As finalized, hospices will see a 2 percent ($480 million) increase in their payments for FY 2022. In addition, this rule makes permanent selected regulatory blanket waivers that were issued to Medicare-participating hospice agencies during the COVID-19 public health emergency (PHE) and updates the hospice conditions of participation. This rule updates the Hospice Quality Reporting Program and finalizes changes beginning with the January 2022 public reporting for the Home Health Quality Reporting Program to address exceptions related to the COVID-19 PHE. These regulations are effective on October 1.