Every US senator and House representative from New York signed a letter last week urging the Centers for Medicare & Medicaid Services, the Office of Management and Budget, and President Joseph Biden to reverse proposed home health reimbursement cuts.
“The proposed rule threatens the ability of home health care providers to care for our nation’s senior citizens, people with disabilities, and other vulnerable populations,” they wrote. “We urge you to consider pausing this rule change and refine your approach in determining budget neutrality in home health.”
In June, CMS issued its proposed home health rule for 2025, which included a net -1.7% permanent payment adjustment to Medicare home health rates. The proposal followed multiple years of home health cuts — notably, reductions of 3.925% in 2023 and 2.89% in 2024 — amounting to a cumulative economic impact of more than $8 billion since 2020, according to the letter. CMS has also vowed to “claw back” billions more of supposed overpayments related to the industry’s switch to the patient-driven groupings model in 2020.
The lawmakers noted that these ongoing and repeated cuts to Medicare home health rates have had a direct impact on patients’ quality of care, particularly in New York. A growing share of Medicare beneficiaries have had their access to home health reduced in recent years, and New York’s share of home health agencies shrunk by 13% between 2019 and 2023, they said. In the same time period, hospital lengths of stay increased by about 9%, which suggests that patients are waiting longer to be discharged safely, they said.
These trends are not unique to New York, the lawmakers said. Rather, they are indicative of the situation occurring nationwide.
“Nationally, there was a 22.4% decline in the rate of Medicare enrollees receiving home health care between 2019-23,” they wrote. “Every state experienced a loss of access, ranging from 3.6% (North Dakota) to 32.3% (Maine). An estimated 2.6 million patients annually who are referred to home health care are never accepted by a home health agency.”
The letter garnered praise from industry advocates including the Home Care Association of New York (HCANYS).
“Our state’s congressional delegation deserves the appreciation of all New Yorkers for this direct, impassioned request to the White House, President Biden, and his cabinet officials to halt these unprecedented CMS’s cuts to Medicare home health,” Al Cardillo, president of HCANYS, said in a statement. “We hope that the president and administration will positively respond to the delegation’s concerns that CMS’s mounting cuts will only further diminish access to home health services at the very time that the need for them is ever rising.”
Dan Savitt, chief executive officer of VNS Health, a large New York home health provider, also thanked the congressional delegation for its effort to block home health cuts in a statement last week.
