In The News

CALL TO ACTION: 2023 Proposed Home Health Rule

HHAC stands with the National Association for Home Care and Hospice (NAHC) in combating several of the key provisions found in the 2023 Proposed Home Health Rule, and echoes the statement made by NAHC President, Bill Dombi, that: 

"With significantly rising costs for staff, transportation, and more, home health agencies across the country cannot withstand the impact of the proposed rate cut. Reliable analyses proves that PDGM underpaid home health agencies. We will be taking all steps to protect the home health benefit as this proposed rule advances and have fully prepared for congressional action and more.” 

According to a recent analysis performed of available data, NAHC estimated that should the proposed rule pass in its current form, 37% of free-standing home health agencies and 50% of all non hospital-based agencies would be operating at <0% net margin. 

The best time to begin our grassroots efforts against the destructive proposed changes will be when Congress is at recess in August. In the meantime, please use this link to go to the Federal Register and submit a formal comment about the rule. Let CMS and Congress know what it would do to your agency and those you care for. Comments must be submitted by 08/16/2022 to be considered. 

Resources: 

 

Dems Want to Tax High Earners to Protect Medicare Solvency

Associated Press / By ALAN FRAM
 
WASHINGTON (AP) — Senate Democrats want to boost taxes on some high earners and use the money to extend the solvency of Medicare, the latest step in the party’s election-year attempt to craft a scaled-back version of the economic package that collapsed last year, Democratic aides told The Associated Press.
 
Democrats expect to submit legislative language on their Medicare plan to the Senate’s parliamentarian in the next few days, the aides said. It was the latest sign that Majority Leader Chuck Schumer, D-N.Y., and Sen. Joe Manchin, D-W.Va., could be edging toward a compromise the party hopes to push through Congress this summer over solid Republican opposition. Manchin scuttled last year’s bill.
 
Under the latest proposal, people earning more than $400,000 a year and couples making more than $500,000 would have to pay a 3.8% tax on their earnings from tax-advantaged businesses called pass throughs. Until now, many of them have been using a loophole to avoid paying that levy.
 
That would raise an estimated $203 billion over a decade, which Democrats say would be used to delay until 2031 a shortfall in the Medicare trust fund that pays for hospital care. That fund is currently projected to start running out of money in 2028, three years earlier.
 
Most U.S. businesses are pass throughs, which include partnerships and sole proprietorships and range from one-person law practices to some large companies. Owners count the profits as income when they pay individual income taxes, but such companies do not pay corporate taxes — meaning they avoid paying two levels of taxation.
 
Democrats this week also sent the parliamentarian a separate 190-page piece of the emerging Schumer-Manchin compromise that would lower prescription drug costs for patients and the government. Provisions include requiring Medicare to negotiate drug prices, limiting beneficiaries’ out-of-pocket costs to $2,000 annually and increasing federal subsidies for copays and premiums for some low-income people.

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Health Care Fraud and Abuse Control Program FY 2021 Report Issued

From the Health Group

The Department of Health and Human Services and the Department of Justice have released the Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2021

During FY 2021, the federal government won or negotiated more than $5 billion in health care fraud judgments and settlements.  The Report provides highlights of significant criminal and civil investigations by type including:

  • Ambulance transportation services
  • Clinics
  • Diagnostic testing
  • Drug companies
  • Durable medical equipment
  • Electronic health records
  • Genetic testing
  • Home health providers
  • Hospice care
  • Hospitals and health systems
  • Laboratory testing
  • Managed care
  • Medical devices
  • Nursing homes and facilities
  • Pharmacies
  • Physical therapy
  • Physicians and other practitioners
  • Prescription drugs and opioids
  • Psychiatric and psychological testing and services
  • Substance use treatment centers

The Report provides an all-inclusive look into the current and potential activities relating to the identification and pursuit of fraudulent and abusive activities, including Medicare provider screening.  All providers should be continuously aware of areas of focus as described in the Report.  The entire Report is available at FY 2021 HCFAC Report (hhs.gov).

 

MEDPAC Releases June Report to Congress

The Health Group 

The Medicare Payment Advisory Commission (“MedPAC”) has released the June 2022 Report to Congress, Medicare and the Health Care Delivery System.  The Report includes seven (7) chapters devoted to:

  • · Ways to streamline and harmonize Medicare’s portfolio of alternative payment models,
  • · Vulnerable Medicare beneficiaries’ access to care,
  • · A framework for identifying safety-net providers,
  • · Addressing the high prices of drugs covered by Medicare Part B,
  • · Improving the accuracy of Medicare Advantage payments,
  • · Aligning fee-for-service payment rates across ambulatory settings, and
  • · Segmentation in the stand-alone Part D prescription drug plan market.

The entire Report is available here

 

The Case for Integrating Social Determinants Into Palliative Care

Hospice News / By Jim Parker

Individually, palliative care and social determinants programs both have the potential to improve quality of life and reduce costs — but that potential may be greater when the two are combined.

Social determinants are non-medical needs that can have a significant impact on the trajectory of patients’ health, such as nutrition, transportation, social or caregiver support, and housing, among others. Social and economic factors like these drive 40% of health outcomes, according to the Better Medicare Alliance.

With the care model’s focus on patients’ goals and quality of life, palliative care providers may be uniquely suited to assess those needs, according to Terri Maxwell, general manager, chief clinical officer, and co-founder of Turn-Key Health, a CareCentrix company.

“The interdisciplinary nature of palliative care, especially the inclusion of social workers, positions palliative care nicely to help to address the myriad needs that people have,” Maxwell told Hospice News. “Palliative care is well positioned to be able to positively close gaps related to social determinants of health — if a program is structured to uncover what those gaps are.” 

Integrating social determinants of health into community-based palliative care improves patient outcomes and can reduce higher-acuity care, which can help providers demonstrate their value to payers.

Home-based palliative care could reduce societal health care costs by $103 billion within the next 20 years, the nonprofit economic research group Florida TaxWatch indicated in a 2019 report

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