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Lobbying, legislation and legal action are all levers the National Association for Home Care & Hospice is prepared to pull to fight the proposed 4.2% Medicare home health payment cut, NAHC President and CEO William Dombi told members Thursday.

William Dombi headhot
William Dombi

“It’s a very delicate kind of an action because we have to do so in ways where the Congressional Budget Office doesn’t end up saying [rolling back the cuts] costs billions of dollars and you have to pay that.” Dombi said during a webinar that day.  

The Centers for Medicare & Medicaid Services announced the 2023 home health payment rule one week ago. The rule would reduce Medicare payments to home health agencies by $810 million annually. The public has 60 days to file formal comments to CMS about the proposed rule. CMS is expected to issue the final 2023 home health rule in late October. 

Dombi said there is a chance CMS would walk back the proposed cut if it considers more recent economic data from the second and third quarters of 2022 that better reflect inflationary pressures from higher borrowing costs, fuel prices and rising wages.

“We have seen in 2021 and 2022 an absolute increase in labor costs as part of their visits of delivering care and those labor costs are definitely coming close to 10% for a year’s period of time,” Dombi explained. 

Among the actions the association is pursuing is talking to members of Congress about potentially sponsoring a bill that would roll back the proposed rule. If neither lobbying nor the threat of legislation prevents the cut, Dombi said NAHC would challenge the final rule in court. But even he admitted that could be an uphill battle.

“Once the rule becomes final, then we have to have a claim presented to the Medicare program, meaning we have to get into 2023 before we could submit a lawsuit,” Dombi said. “Even then, what the courts have said very definitively is we have to exhaust all administrative remedies.”