U.S. Capitol dome

Home care providers are pushing for an end-of-the-year government funding package to include legislation that would postpone the 2023 home health cut of 3.925% for one year and require the Centers for Medicare & Medicaid Services to offer transparency in its rate setting going forward.

“All eyes at this point are on the funding package to fund the government through the remainder of the fiscal year,” Calvin McDaniel, director of government affairs for the National Association for Home Care & Hospice, said Friday in a NAHC congressional advocacy webinar.

The home health legislation — which has not yet been introduced — is a version of the  Preserving Access to Home Health Act of 2022, which Sens. Debbie Stabenow (D-MI) and Susan Collins (R-ME) introduced in July, McDaniel explained. Stabenow is leaning on Senate leaders Ron Wyden (D-OR) Chuck Schumer (D-NY) to include amended language in the funding bill, McDaniel said.

Stabenow “has been an absolute dog with a bone on this one,” noted McDaniel, who also pointed out that the Medicare Payment Advisory Commission’s recommendation on Friday to slash Medicare funding for home health due to a 24.9% profit margin does not help the industry’s case to delay the home health cut.

NAHC is working to shape the government funding package, which would need 60 votes to pass, with other home care legislative priorities. Hospice’s main priority is to block language in a package that would mention a reduction in the hospice aggregate cap, Davis Baird, director of government affairs, hospice, for NAHC, said Friday. Unlike on the home health side in which there is a specific CMS rule, “the threat for hospice is really less concrete, a little more nebulous,” Baird said.

“We just heard in recent weeks a major reduction to the hospice aggregate is being pushed by a few key staffers on Capitol Hill,” he said.

MedPAC in 2020 first issued the recommendation to wage-adjust and reduce the cap by 20%. Again, on Friday, MedPAC recommended reducing the hospice aggregate by 20%.

Additional legislative action items of interest to NAHC that may make it into the funding packaging are the following: a PAYGO cut waiver, relief from physician reimbursement cuts, a one-year extension of telehealth flexibilities, an extension of Medicaid funding for United States territories, and mental health and substance use disorder policies. The latter is a “leading extender for some action during the next couple of weeks,” Baird said.

Government funding official runs out this Friday. A short-term funding extension until Dec. 23 or after Christmas is the likely course of action, McDaniel said.