In The News

Home Health CAHPS Participation Exemption Request Deadline


The deadline for home health agencies to submit a request for an exemption from participating in the Home Health CAHPS (HH CAHPS) Survey for the CY 2023 Annual Payment Update (APU) is March 31, 2022.

Medicare-certified home health agencies are eligible for an exemption if they served 59 or fewer survey eligible patients between April 1, 2020, and March 31, 2021. If your agency is exempt, you do not need to participate in the HHCAHPS data collection period, which runs from April 1, 2021 through March 31, 2022.

To be exempted from participating in the HH CAHPS Survey for the CY 2023 APU, HHAs must count the number of home health patients they served between April 1, 2020, and March 31, 2021, who meet HHCAHPS survey eligibility criteria and then report that count on the Participation Exemption Request Form. Please note, exemptions are active for one year only.


New Legislation Would Extend the Hospital at Home Program


The bipartisan Hospital Inpatient Services Modernization Act is new legislation introduced in both the Senate and House of Representatives that would extend the acute care hospital at home waiver program. Initially introduced in November of 2020, during the height of the COVID-19 public health emergency (PHE), the program provides an alternative setting of care for certain conditions, such as asthma, pneumonia, and COPD.

As of February 2022, there were 92 health systems and 202 hospitals in 34 states participating in the hospital at home waiver program.

According to the legislation, upon completion of the PHE, the Hospital Inpatient Services Modernization Act would trigger a two-year extension of the hospital at home waiver, as well as require an evaluation of the program by the Department of Health and Human Services with recommendations for additional legislation and administrative action as the Secretary of HHS sees appropriate.

At introduction Senator Tim Scott heralded the new bill stating, “The Acute Hospital Care at Home program has revolutionized health care for many Americans by improving care while decreasing health risks associated with hospital stays. I’m proud to extend this program that will ease pressure on our health care system and allow thousands of vulnerable Americans to continue receiving quality care from the safety of their own home.”

Rep. Brad Wenstrup added, “The COVID-19 pandemic exposed deficiencies in our current health care system, and forced us to develop new, innovative solutions to deliver care for patients. As a Co-Chair of the GOP Doctors Caucus and a physician, I recognize the value of giving providers more tools to offer appropriate methods of care, one being in the comfort of patients’ homes. Everyone has different treatment needs and plans, and we must make sure that people have continued access to these options as Congress reviews how to make the initial flexibilities from the pandemic more permanent in an appropriate manner.”

NAHC thanks Senators Tom Carper (D-DE) and Tim Scott (R-SC), and Representatives Earl Blumenauer (D-OR) and Brad Wenstrup (R-OH) for introducing the Hospital Inpatient Services Modernization Act.

NAHC supports this legislation and will continue to report on further developments related to it.


Becerra Shoots Down Giving More than 60 Days Notice on Ending COVID-19 Public Health Emergency

Fierce Healthcare / By Robert King
Giving more than 60 days notice that the COVID-19 public health emergency will end is going to be difficult, as states and lawmakers have pressed for a longer heads-up, according to Department of Health and Human Services (HHS) Secretary Xavier Becerra.

The secretary spoke with reporters Friday during a press conference that included remarks on the status of unwinding the public health emergency (PHE) and how the agency’s COVID-19 relief efforts will be impacted if Congress doesn’t approve additional funding. 

The healthcare industry and states are waiting to find out when the PHE will end and with it the loss of key flexibilities for telehealth reimbursements and the start of eligibility redeterminations for Medicaid. 

The current PHE is scheduled to expire April 16 and will likely be extended again for 90 days. HHS has promised to give at least a 60-day notice when the PHE will expire for good. 

However, Republicans in Congress, payer groups and states have asked for more advance notice to get ready for the unwinding of the PHE. Several hospital groups have also asked for more notice as they must prepare for the end of the PHE’s requirement that Medicaid programs not disenroll beneficiaries. 

Becerra conceded, though, to reporters that it is “tough to give much more than 60 days” notice. 

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President Signs Omnibus Spending Bill

The Health Group

Last week President Biden signed into law a $1.5 trillion spending package, referred to as an “Omnibus Spending Bill”.  The legislation will fund the government through September 2022.  The Bill also provides significant financial assistance to Ukraine.

For hospices, the Bill includes an extension of the flexibility for hospices to meet the requirement for a face-to-face visit for recertification of eligibility through a virtual visit for 151 days after the end of the COVID-19 PHE.  This face-to-face flexibility was part of the CARES Act in 2020.  The PHE, expected to end this summer, will allow this flexibility to continue for an additional 151 days or until December 2022.

The bill also contains a one-year extension, from FY2030 to FY2031, of the existing formula used in calculating the annual update to the hospice aggregate limitation (“CAP”). 

Unfortunately, the legislation does not include any extensions of the Medicare sequester moratorium. The sequester, suspended during the PHE, is effective April 1, 2022, with a one percent (1%) reduction in Medicare payments.  The sequester will be a two percent (2%) reduction in Medicare payments starting July 1, 2022.  


CMS has published information needed for Medicare Advantage Organizations (“MAOs”) interested in participating in the Hospice Benefit Component of the VBID Model, including the scope of the benefit, as well as policies relating to the quality, networking, and payment policies.  Additional information is available at Medicare Advantage Value-Based Insurance Design Model | CMS Innovation Center and VBID Model Hospice Benefit Component Overview | CMS Innovation Center.

CMS will be hosting a session on Tuesday, April 5, 2022, to discuss the Medicare Advantage Value-Based Insurance Design (“VBID”) Model and its Hospice Benefit Component.  Information is available at Office Hours: 2023 Medicare Advantage Value-Based Insurance Design Model and its Hospice Benefit Component | CMS Innovation Center. 


Home- and Community-Based Services Are a Safe Bet

McKnight’s Home Care / By Liza Berger

If you like to gamble and know a thing or two about post-acute care, it seems pretty clear where to put your money at this point: home- and community-based services (HCBS).

Two developments in recent days helped make that case. One is a new report from the Kaiser Family Foundation, which found that the realignment of long-term services and supports (LTSS) toward HCBS keeps moving in that direction. In fiscal year 2019, the most recent year in which data are available, HCB LTSS made up 59% of total spending — the highest to date — while institutional LTSS comprised 41% of total spending. The gulf has continued to widen since fiscal year 2013, when HCBS surpassed institutional care in the share of LTSS dollars.

Another, perhaps even more significant indication came from a key source: Jennifer Bowdoin, Ph.D., director of the Division of Community Services Transformation for the Centers for Medicare & Medicaid Services. During a session this week of the legislative and regulatory conference of the National Association for Long Term Services and Supports, she pointed out that there is strong legislative and regulatory momentum toward home- and community-based services. The reasons by now are clear. It is where people want to receive services and it has proven to be less costly than institutional care.

As an example, states are using the funds designated from Section 9817 of the American Rescue Plan to bolster their HCBS. It is estimated they are spending $25 billion on HCBS from the investment. For those that need more of an incentive to grow HCBS, there is a ripe carrot dangling in the form of the Money Follows the Person demonstration program, which offers a higher reimbursement rate and more flexibility to provide additional HCBS services, she pointed out.  

All of this is probably not new to home care providers, who have to be in-the-know on state funding and rules regarding services. But it’s nice to see that when it comes to healthcare policy and payments, there’s no place like home.

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