Current federal legislation to impact post-acute providers

Netsmart continues to be a strong advocate for selected federal legislation on behalf of our clients and providers across the country. Here are several current areas of focus. 

S. 433/H.R. 2573: Home Health Payment Innovation Act of 2019

This legislation has been introduced in Congress to address major concerns with the Patient Driven Groupings Model (PDGM), a completely new payment model for home health services effective January 1, 2020.

The Center for Medicare and Medicaid Services (CMS) plans to implement PDGM with an 8.01%
first-year base rate reduction for home health providers based on assumptions of provider behavioral under the new payment system. It is estimated that this action could reduce payments in the Medicare Home Health Program by an estimated $1.298 billion in 2020, cause instability to all providers, threaten access to care, and harm the Medicare home health program for seniors. 

The bills require CMS to use actual changes in provider behavior based on claims and other data after PDGM is implemented instead of assumed behavior as the basis for payment changes to providers. The legislation also reinforce the need for any new model to be budget neutral and limits an agency’s losses or gains to 2% per year.

Netsmart is collaborating with the Partnership for Quality Home Healthcare and the National Association for Home Care & Hospice (NAHC) on advocacy on this important issue, both at the legislative and regulatory levels. Mike Dordick, President of McBee Associates – an industry-leading healthcare consulting firm and now a division of Netsmart – is guiding the advocacy efforts for Netsmart.  

See the Home Health Care News article, CMS Proposal Takes Home Health Agency Closure Estimates and Lights Them on Fire, for more information about PDGM and the proposed legislation. 

YOUR CALL TO ACTION:  Please contact your members of Congress today at this link, provided by the Partnership, to urge their support for these important bills that address the major concerns around the PDGM. It takes just a minute … your voice can make a difference for the future of home health care.

FCC Connected Care Telehealth Pilot Program

This $100 million pilot program proposes an 85% discount on connectivity for broadband-enabled telehealth services that connect patients directly to their doctors to treat a wide range of health conditions. These services aim to facilitate the effective treatment of chronic conditions outside of the doctor’s office at significant savings for patients and health care providers.

The Notice of Proposed Rulemaking seeks comment on testing the new program. Several Netsmart client communities appear to meet the proposed eligibility requirements, including home health and skilled nursing facilities.

Netsmart will provide comments in response to the NPRM about the importance of funding under-resourced providers that serve persons with chronic, often co-occurring health conditions.