Two Republican senators are urging the Centers for Medicare and Medicaid Services (CMS) to “use full authority under law” to preserve the Medicare home health agency (HHA) benefit.

Senators Marsha Blackburn (R-Tennessee) and Susan Collins (R-Maine) sent a letter to CMS Administrator Dr. Mehmet Oz, expressing concerns about the future of the benefit, including payment cuts that could cause more HHAs to shut down. Home-based care advocates applauded the message, saying that policymakers must take action to protect the benefit.

In 2018, the Bipartisan Budget Act (BBA) directed CMS to develop a new payment model for HHAs starting in January 2020. Congress mandated that this model be budget-neutral, and the Congressional Budget Office indicated that the change in payment method would not cause any spending differences for the program.

As a result, the Patient-Driven Groupings Model (PDGM) began in January 2020. When implementing this new model, CMS reduced payments for HHAs. CMS has cut funding each year, leading to delays in care initiation, fewer in-home visits and diminished benefits, Blackburn and Collins said.

Blackburn and Collins stated they were “troubled” that budget cuts are eroding access to home health benefits and that HHAs have closed or reduced service areas in response.

“We request that you use the full authority under the law and pause any planned payment cuts in the CY 2026 Proposed Rule for HHAs and allow clinician experts, seniors, and their families and CMS to discuss system improvements that sustain care, improve quality and contain health care cost growth,” the senators wrote. “We believe that doing so is essential to preserving this vital benefit and ensuring seniors can continue to receive care where they want to be most – at home.”

In conclusion, the senators asked for a response by July 7.

The letter has gained backing from the National Alliance for Care at Home (The Alliance).

“The Alliance is deeply grateful to Senators Blackburn and Collins for their continued leadership and advocacy on behalf of the millions of seniors who depend on Medicare home health services,” Alliance CEO Dr. Steve Landers said in a statement. “CMS’ reductions to home health reimbursement – the most cost-effective care setting – are pushing our seniors into hospitals and expensive institutional facilities, driving up costs for taxpayers while compromising patient outcomes through increased readmissions and higher mortality rates.”

He suggested that policymakers focus on addressing fraud and abuse, as well as expanding value-oriented innovation, rather than implementing across-the-board cuts.

“We must act now to focus on preserving and protecting this essential benefit that keeps patients healthy, safe, and where they want to be – at home with their families,” he wrote.