U.S. Capitol dome

Home care providers have asked Congress to include a measure in end-of-the-year omnibus legislation that would suspend implementation of the final home health rule that includes a $635 million cut to home health providers starting in 2023.

“CMS [Centers for Medicare & Medicaid Services] has portrayed the recent action as an increase in Medicare spending on home health services, but that is a fiction or, at best, highly misleading,” the National Association for Home Care & Hospice said in a statement Monday.

The rule, which CMS issued last month, includes a 4% market-basket increase alongside a phased-in -7.85% behavioral adjustment related to the Patient-Driven Groupings model. The rate cut will be -3.925%, or $635 million, for 2023, starting on Jan. 1. Providers, who believe the rate cut is based on flawed methodology, expect the total adjustment will trigger an estimate $18 billion in payment reductions over the next decade.

Calvin McDaniel, direct of government affairs for NAHC, explained to McKnight’s Home Care Daily Pulse Monday that the omnibus legislation would provide government funding for the remainder of the fiscal year and also incorporate other spending priorities. Government funding is set to run out on Dec. 16, he said.

“We’re in for a busy stretch the next few weeks as that package comes together,” he said.

He noted that Sen. Debbie Stabenow (D-MI) is leading the charge on the home health provision in the legislation. Stabenow is co-sponsor of the Preserving Access to Home Health Act of 2022, which would delay the home health cuts until 2026. The House has introduced a companion bill.

Other lawmakers also are pushing for inclusion of the Preserving Access to Home Health Act of 2022 in the omnibus bill preventing the home health rule from taking effect.

“We do have great champions on this,” he said. “We’ve got everybody within Congress that knows this is a problem. We’ve got a lot of folks out there that are acknowledging that these are devastating cuts, that … CMS might be out of balance on this one.”