Home Health Leaders Commend Bipartisan Legislation Blocking Profound Cuts to Medicare Home Health

Medicare cuts totaling $10B over next decade constitutes a 'battle for the future of health care at home,' one home health leader says.

Home health leaders are cheering U.S. Senate bipartisan lawmakers for introducing new legislation that prevents a newly proposed 7.69% permanent cut and an additional $2 billion in “clawback” cuts to home health care services included in the Centers for Medicare & Medicaid Services’ (CMS) Home Health Prospective Payment System (HHPPS) for 2023.

Co-sponsored by U.S. Sens. Debbie Stabenow (D-Michigan) and Susan Collins (R-Maine), “The Preserving Access to Home Health Act of 2022” would delay the 7.69% payment cut proposed for 2023, which would total $1.33 billion in 2023 alone, according to a press release from The Partnership for Quality Home Healthcare (The Partnership) and the National Association for Home Care & Hospice (NAHC).

The bill would also block additional cuts of more than $2 billion as soon as 2024 due to an “unjustified clawback” of payments for critical home health care services delivered to seniors and people with disabilities during the pandemic, the press release says.

Estimates show Medicare’s proposed cuts will total $18 billion to providers over the next 10 years.

“We applaud Senators Stabenow and Collins for introducing this legislation, which will protect home health patients and providers from extreme cuts and help ensure continued access to safe, patient-preferred home health care for millions of American seniors and individuals with disabilities,” said Joanne Cunningham, CEO of the Partnership. “While we continue to educate CMS on the overall impacts of their proposed cuts, we commend lawmakers in Congress for proactively offering legislative solutions to these harmful payment adjustments.”

The legislation will make these policy changes: 

• Prevent CMS from implementing any permanent or temporary adjustment to home health prospective payment rates prior to 2026. This would delay cuts currently proposed by CMS for 2023 and beyond, allowing more time for CMS to refine its proposed approach to determining budget neutrality in home health.
• Ensure that any adjustments CMS determines to be necessary to offset increases or decreases in estimated aggre­gate expenditures are made by 2032, such that no cuts would be delayed beyond the end of the budget window.
• The legislation is intended to be self-implementing. It would become effective as of the date of enactment and includes instructions allowing for implementation by program instruction or other means.

Home health leaders have consistently expressed concerns about CMS’ method in proposing these payment adjustments, particularly in light of significant increases in labor and supply costs across the home health community. An August 2021 labor cost survey of home health providers concluded that wages and home health industry expenses have increased dramatically since 2019—a trend that continues to worsen as inflation hits its highest point in decades.

“Home health providers are facing enormous pressures today, including historically high costs of delivering quality home health care, so these severe and unjust cuts could not come at a worse time,” Cunningham said. “We look forward to working with lawmakers in Congress to build support for this legislation to ensure Medicare’s proposed cuts are not implemented as proposed.”

Home health leaders will work with lawmakers to build support for the legislation, they say.

“This is a battle for the future of health care at home,” said William A. Dombi, NAHC president. “We sincerely hope that CMS will support this legislation and recognize the need to work with us to avoid the harm that the current proposal would inflict.”