As different health care stakeholders combed through the new $1.4 trillion spending package approved by Congress on Monday, many likely felt a mix of excitement and disappointment.
Included in the nearly 6,000-page spending package was a $900 billion COVID-19 relief bill, changes to home health therapy rules, certain hospice provisions and more. That’s really just the tip of the iceberg, too, as it’s unlikely that even the lawmakers who voted on the package read it in its entirety.
Home-based care insiders are in the process of doing so. So far, there’s reason to be happy about the relief package, which now awaits President Donald Trump’s signature.
“We are grateful that Congress recognized the need to support home care and hospice during the pandemic,” William A. Dombi, the president of the National Association for Home Care & Hospice (NAHC), told Home Health Care News in an email.
In addition to the previously noted items, Dombi called attention to the package extending the Medicare sequestration holiday, which was initially set to expire at the end of this month. More CARES Act grants, an extension of the Medicaid Follows the Person (MFP) program and extra spousal impoverishment relief are likewise victories for home health and hospice operators, NAHC’s president said.
“[There is also] the expanded SBA Paycheck Protection Program (PPP) and more that will help keep [home health] and hospice operational,” Dombi added.
Specifically, $284.5 billion more has been added for a second round of PPP loans for businesses with less than 300 employees and a demonstrated revenue loss greater than 25%.
The extended sequestration suspension is a major win for all Medicare-reimbursed health care providers, which have faced a 2% cut since 2014. Providers across the country continue to deal with new, previously unexpected expenses and erratic revenue patterns.
The new pause on sequestration runs through March 31.
Additionally, the spending package and COVID-19 relief includes nearly $70 billion to purchase and distribute vaccines, plus funds to help states conduct testing. About $20 billion of that funding will be dedicated to making the vaccine available at no cost for certain individuals.
Other COVID-19 specifics include $22.4 billion for testing, contact tracing and other prevention practices necessary for combatting the virus. Another $3 billion was included for additional grants for health care providers to be reimbursed for expenses or lost revenues tied to COVID-19.
For Medicare-funded home health businesses, $175 billion more has been put into the Provider Relief Fund, which could grant them a lifeline until the pandemic subsides.
Similar to NAHC, the American Occupational Therapy Association (AOTA) celebrated certain provisions on the $1.4 trillion spending package.
In what AOTA called a “historic home health victory,” the package includes language from the Medicare Home Health Flexibility Act that enables occupational therapists (OTs) to open home health therapy cases. The U.S. Centers for Medicare & Medicaid Services (CMS) will have one year to implement a rule allowing for that change.
“Today we celebrate hard-fought victories for occupational therapy scope of practice and payment, following extensive AOTA-led advocacy initiatives,” the advocacy organization wrote in a statement.
OTs were granted the flexibility to open up home health cases during the public health emergency, but this bill will allow them to do so moving forward. AOTA said it has worked for “decades” on this measure.
The bill also made COVID-19-related telehealth flexibilities permanent.
Funding for hospice providers, small businesses
The “Rural Access to Hospice Act” and the “Helping our Senior Populations in Comfort Environments (HOSPICE) Act” were also included in the spending package.
Rural health clinics and federally qualified health centers cannot currently bill under Medicare Part B for hospice, which often becomes a barrier to caring for remote populations. With the Rural Access to Hospice Act in place, providers will be able to receive payment for services to patients in hospice, which will help those populations.
The National Hospice and Palliative Care Organization’s (NHPCO) was happy with the hospice provisions.
“NHPCO appreciates this bi-partisan, bi-cameral agreement,” NHPCO President and CEO Edo Banach said in a statement. “Hospice patients and families will benefit from improved access in rural and underserved communities as well as needed relief during this public health emergency. This legislation will enable hospice providers to continue providing uninterrupted care during this unprecedented time.”
Adult day providers weren’t as lucky. There were no specific provisions aimed at helping those operators during the public health emergency.
Katie Smith Sloan, the president and CEO of the aging-focused organization LeadingAge, previously discussed how Congress has fallen short in its efforts when it comes to helping adult day centers around the country.
What may help these providers, as well as other home care organizations, is the new round of PPP money that’s included in the package. If they are able to qualify, which most should be able to, that will at least ease some of the payroll burden that they’ve faced amid the public health emergency.