Industry-backed legislative efforts to take the teeth out of proposed home health payment reform are gaining ground on Capitol Hill.
On Thursday, Rep. Ralph Abraham (R-La.) introduced H.R. 6932, a new bill that amends several provisions of the Bipartisan Budget Act of 2018 to thwart widely opposed behavioral adjustment aspects of the Patient-Driven Groupings Model (PDGM), introduced by the Centers for Medicare & Medicaid Services (CMS) in July.
Specifically, the bill requires policymakers to implement adjustments to reimbursement rates only after behavioral changes by home health agencies affecting spending actually occur and are observed. The bill’s goal is to ensure a smoother transition to a new payment system that could be one of the biggest shakeups to the home health system in decades, according to the Partnership for Quality Home Healthcare.
Rep. Scott DesJarlais (R-Tenn.), Rep. Vern Buchanan (R-Fla.), Rep. Terri Sewell (D-Ala.) and Rep. Garret Graves (R-La.) are among H.R. 6932’s current co-sponsors.
News of the House bill comes a little over a week after a companion bill — S. 3458 — was introduced in the Senate. Republican Sen. John Kennedy of Louisiana introduced the Senate version, which was also sponsored by Sen. Bill Cassidy, a fellow Louisiana republican.
“The Partnership applauds this group of Senate and House lawmakers for introducing these vital pieces of legislation, which will better align Medicare payment with patient care by ensuring payment adjustments are made based on observed behavioral changes among providers,” Partnership Chairman and LHC Group (Nasdaq: LHCG) CEO Keith Myers said in a statement. “With more and more seniors — especially seniors who are frail and suffer from multiple chronic conditions — requiring home healthcare, it is critical that payment reforms are based on actual behaviors, not arbitrary assumptions, so that home healthcare services are not disrupted.”
Paul Kusserow, CEO of Amedisys (Nasdaq: AMED), likewise expressed his support for S. 3458 during the 2018 Home Health Care News Summit in Chicago.
LHC Group and Amedisys are the two largest publicly traded and independent home health companies in the country.
In addition to targeting PDGM behavioral adjustments, the two pieces of legislation would require all necessary increases or decreases in payment rates to be phased in at a ceiling of no more than 2% per year.
Up to half of all home health agencies could see significant reductions in Medicare payment without the behavioral adjustment changes included in S. 3458 and H.R. 6932.
The House bill was introduced and referred to the Committee on Ways and Means and the Committee on Energy and Commerce. The Senate version was referred to the Senate Committee on Finance.
The National Association for Home Care & Hospice (NAHC) has also voiced support for the bills.
“When enacted, these legislative proposals will go a long way to ensuring that the benefits of home health care are fully realized,” NAHC President William Dombi said in a statement.
Written by Robert Holly