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Key Homecare Messages for Congress Readied for Washington Conference Next Week
02 Jun 2005 - Hundreds of homecare providers will meet with Members of Congress next week during AAHomecare's Washington Leadership Conference to deliver key messages about the value of homecare and the need to strengthen homecare policy in the U.S.
Full talking points and issue papers for use on Capitol Hill will be posted on the AAHomecare website, aahomecare.org, on Thursday. These materials can also be used in grassroots lobbying efforts and for meetings with Members of Congress during visits to their home districts. Some of the key messages follow:
Safeguard quality and fair competition under “competitive acquisition” (restrictive contracting) provisions of the Medicare Modernization Act (MMA). Before implementation of this program, CMS must accelerate development of quality standards to create a level playing field for providers and ensure that standards for necessary clinical support are in place so beneficiaries receive the quality of care they deserve. CMS should allow any qualified provider to compete. It should not limit the number of homecare providers if they can meet prescribed prices and quality standards.
Increase the dispensing fee for inhalation drug therapies to account for inflation and associated service expenses to ensure that these patients continue to receive quality therapy in their homes, and to prevent hospitalization. Home inhalation drug therapy provides critical care to nearly one million Medicare beneficiaries suffering from chronic obstructive pulmonary disease and other respiratory illnesses.
Strengthen the home health benefit. Evidence demonstrates that home healthcare is more cost effective than care in other settings. Through implementation of best practices, home health agencies are enabling patients to receive clinically effective services in the most appropriate, consumer-preferred healthcare setting. The Medicare home health benefit is clearly defined in law and regulation. The typical home health patient is being treated by a home health agency for acute conditions as well as multiple chronic illnesses. The principle of rebalancing resources between institutional and home and community-based services in Medicaid, which the Administration advocates, is equally applicable and valid for the Medicare program.
Ask CMS to clarify the new Medicare coverage policy for mobility assistive equipment. Documentation guidelines for mobility assistive equipment must be clear, and CMS must work with stakeholders and issue clear guidance and a revised certificate of medical necessity. Also, the “in-the-home” restriction for Medicare coverage of mobility equipment must be eliminated so beneficiaries can access community, work, school, doctors, or places or worship.
Remember: Homecare delivers value for Medicare and Medicaid. A recent survey of medical literature shows the cost-effectiveness of homecare, which HHS Secretary Leavitt recently described as “radically” more efficient than institutional care. Studies published in the Journal of the American Medical Association, the New England Journal of Medicine, and other sources support the value of homecare.
Strengthen homecare to address America's healthcare crisis. Homecare provides patient-preferred, cost-effective care to millions of Americans. It is part of the answer to America's healthcare crisis. AAHomecare members urge Congress to protect home medical equipment and home health from further cuts.
Your Opportunity to Comment to OMB on Burden of Home Health ABN Changes
CMS is requesting approval of the Office of Management and Budget (OMB) for a revised Home Health Advance Beneficiary Notice (HHABN) to be effective July 1. The public has until June 6 to comment to OMB on the revised forms and the associated burdens. HHABNs are to be given to beneficiaries under the following circumstances:
1. For initiation of non-covered care or reduction of previously non-covered care, e.g. chore services.
2. For reduction of previously covered or non-covered care for financial, staffing, safety, or other reasons.
3. For cessation of all services whether covered or non-covered when there is no expedited determination notice. The new BIPA Expedited Determination Notice is for beneficiaries who wish to appeal termination of their services to the state Quality Improvement Organization (QIO). This process applies to terminations based on services not being reasonable and necessary or not meeting the definition of the benefit, e.g. not homebound. For a beneficiary to take advantage of the expedited QIO appeals process, a physician must state in writing that discontinuation of home health services will cause harm.
CMS estimates that it will take six minutes to prepare a HHABN notice. The HHA's obligations include delivering the notice (which can be done on the second to last visit) and ensuring that the beneficiary understands its meaning. In light of this, it is unclear why CMS would estimate to OMB that only 31,000 HHABNs would be issued each year when it appears the number could be in the millions.
If you wish to comment to OMB, you may want to address the following:
-- For what percent of your Medicare episodes would you have to prepare and deliver a HHABN in a year? (This includes changes in services and discharges. Note that reductions or termination in services as specified in the Plan of Care, e.g., SN 3X week for 2 weeks, then SN 1x week for 2 weeks, will not require notice.) For what percentage of beneficiaries would you have to issue more than one notice in an episode, and what would be the average number of notices for such patients?
-- How long will it take to prepare a HHABN form? What would be the cost, including preparation, delivery, and explanation to the beneficiary per each HHABN?
-- Do you have any recommendations for a better way to inform beneficiaries and at the same time alleviate the burden and cost for HHAs?
You can submit you comments to OMB by June 6 by E-mailing to: Christopher J. Martin, Policy Analyst, Office of Management and Budget, 725 17th Street, NW Room 10226, Washington, DC 20503, E-mail address: Christopher_Martin@OMB.EOP.GOV
Still Time to Sign Up for Washington Leadership Conference, June 7-10
Speak up for homecare at AAHomecare's Washington Leadership Conference, June 7-10, 2005 in Washington, DC. AAHomecare is scheduling hundreds of meetings with Members of Congress for attendees. Visit http://www.aahomecare.org for details.
Michael Reinemer, VP, Communications
American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171 703-535-1881
http://www.aahomecare.org
Plan to attend AAHomecare's Washington Leadership Conference, June 7-10 at the J.W. Marriott, Washington, DC. For detail, see http://www.aahomecare.org.
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