Home Health Advocates: Doc Pay Reform Shouldn’t Come Through Medicare Copays

While reforms are necessary to payment policy for the nation’s Medicare physicians, introducing a copayment on Medicare home health beneficiaries isn’t the way to go about it, says a home health advocacy group that is pushing instead for stronger measures against fraud.

The House Ways and Means Committee has invited industry stakeholders to comment on potential changes to Medicare, including a copayment for home health beneficiaries, although it clarified in a Friday statement that such copayments “are not the position of [the Committee].”

Congress repealed a Medicare home health copay in 1972, and the Ways and Means Committee is right to not push for one now, says the Partnership for Quality Home Healthcare. 

“We applaud the Committee for their efforts to improve Medicare payment policy for the physicians who serve Medicare beneficiaries.  However, increasing the financial burden of home health beneficiaries—who are documented as being among the poorest, sickest and oldest in the Medicare program—is the wrong way to finance physician payments or reform Medicare,” said Chairman Billy Tauzin, senior counsel to the Partnership for Quality Home Healthcare, in a statement.  

Instead, lawmakers should focus on “pro-patient” reform policies that don’t limit beneficiaries’ access to home health care, and deliver substantial savings via “targeted integrity and efficiency reforms.” 

In response to the Committee’s request for ideas on how to improve the efficiency and effectiveness of post-acute care, the Partnership is preparing recommendations geared toward bettering the delivery of quality care that will generate significant savings. One such recommendation is to target and combat Medicare fraud and abuse by preventing payment of aberrant claims before they occur and strengthening the claims review process. 

“Positive solutions that protect vulnerable seniors while also delivering billions in taxpayer savings are within reach,” added Eric Berger, CEO of the Partnership. “We look forward to working with the Ways and Means Committee and other leaders in Congress to advance targeted reform policies that improve care for our nation’s seniors, strengthen Medicare program integrity, and improve the efficiency of this vital senior care program.” 

Written by Alyssa Gerace