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House Votes to Avert Looming Medicare Cuts
Modern Healthcare | By Jessie Hellmann
Providers are poised to get relief from pending Medicare cuts under legislation the U.S. House of Representatives passed Tuesday night on a party line vote, 222-212. It now heads to the Senate where it is expected to pass as soon as this week.
The bill falls short of what providers advocated but hospitals are relieved that Congress is taking steps to block tens of millions of dollars in reimbursment reductions slated to take effect next year, American Hospital Association President and CEO Rick Pollack said.
"The AHA is pleased that the House has recognized that now is not the time to make cuts to hospitals and physicians under the Medicare program," Pollack said in a news release. "Providers on the front lines of the fight against COVID-19 will not face additional imminent financial jeopardy as they continue to care for patients and communities."
The legislation, released by the House Rules Committee Tuesday, would delay 2% cuts to Medicare rates through March 2022 and punt a separate round of 4% Medicare cuts totaling about $36 billion to 2023.
The 2% Medicare cuts derive from the 2011 law that created budget sequestration requiring spending reductions across the federal government beginning in 2013. Congress and President Donald Trump delayed the cuts last year as part of the federal pandemic response. The bill would keep that pause in place until April 1, after which providers would see a 1% cut until June 30 and a 2% cut until the budget sequestration expires in 2031.
The 4% Medicare cuts are the consequence a budget law known as PAYGO that requires increases in the deficit be offset by raising revenue or reducing spending. The COVID-19 relief package enacted this year resulted in a larger budget deficit, triggering spending reductions.
The bill also includes a 3% increase in pay for providers paid under the Medicare Physician Fee Schedule.
Lawmakers argue the increase is necessary to avoid payment cuts stemming from changes the Centers for Medicare and Medicaid Services made to the fee schedule last year. Because of a budget neutrality requirement, payment increases for primary care doctors resulted in planned cuts to specialists. Congress stepped in to avert the cuts with a 3.75% increase for all doctors. Physician groups have asked Congress to again extend the pay bump.
"This legislation will bring some stability to the Medicare payment system to ensure patients can keep seeing their doctors," Rep. Kim Schrier (D-Wash.), who authored the bill, said in a news release.
Most House Republicans voted against the bill because it takes steps toward raising the debt ceiling, but it has enough support from Republicans in the Senate to pass. |
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While Court Injunction Is in Place, CMS Will Not Enforce Vaccine Mandate
Two federal court rulings currently in place have created a nationwide preliminary injunction prohibiting the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS) from enforcing the recent Interim Final Rule that requires Medicare-and Medicaid providers subject to Medicare conditions of participation to have all staff vaccinated with some exceptions.
Last Thursday, December 2, CMS posted memo QSO-22-04-ALL, notifying state survey agency directors that it has suspended activities related to the implementation and enforcement of the vaccine mandate found in the Interim Final Rule as a result of the preliminary injunctions that are in effect.
Consequently, State surveyors must not survey providers for compliance with the requirements of the Interim Final Rule. Providers are still subject to State legislation that either mandates or prohibits the mandating of COVID-19 vaccination. |
The 4 Forces Shaping Home Health Care in 2022
Home Health Care News | By Robert Holly
Home health operators each year have to adapt on a number of different fronts, from relatively minor coding updates to major payment adjustments. But in addition to the more run-of-the-mill items, providers occasionally have to navigate macro-level forces that literally change the industry itself.
At least four such forces will redefine home health care in 2022, I believe.
Based on post-acute care dealmaking activity in the second half of 2021, it seems likely that next year will usher in the age of consolidation that everyone anticipated leading up to the Patient-Driven Groupings Model (PDGM), before the COVID-19 pandemic turned the world upside down. The consolidators won’t just be the usual suspects, however.
“I used to get four or five calls a month,” Stoneridge Partners President Rich Tinsley said at FUTURE. “Now, I get two to three a day, and it’s hard to keep up with them.”
Along with consolidation, the ongoing shift to value-based care will take center stage in the form of the Home Health Value-Based Purchasing (HHVBP) Model and Medicare Advantage (MA). Other, more innovative changes within fee-for-service Medicare, such as Choose Home, also have the potential to redefine the traditional home health model.
“I really haven’t yet met with a single congressional staffer or member of Congress since we’ve started where there’s been a response other than, ‘We like this idea conceptually. Now tell us more,’” Joanne Cunningham, executive director of the Partnership for Quality Home Healthcare (PQHH) told me in November in regard to Choose Home.
While consolidation, value-based care and care innovation present exciting opportunities for home health operators, labor forces and the public health emergency will continue to make their mark as well...
Read Full Article |
Invitation to Kepro Program Webinar
You are invited to join Kepro for a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) Program webinar.
Kepro is the BFCC-QIO for 29 states. We offer information and assistance to providers, Medicare beneficiaries, and families regarding Medicare quality of care complaints, hospital discharge and skilled service termination appeals, and Immediate Advocacy services. This webinar will provide a basic overview of these services.
Please note: The webinar will be held using the Microsoft Teams platform. The webinar will not be recorded.
What: A webinar that will provide an overview of BFCC-QIO services
Who: Healthcare providers and stakeholders
When: Wednesday, January 26, 2022, 12:00 - 1:00 pm MT
Registration: Click here to register
Registration details:
- You will receive an email reminder the day before the meeting that will include a link for the meeting.
Please send an email to [email protected] if you have difficulty registering. |
OASIS-D Instrument Use Extended
On November 23rd, 2021 the Office of Management and Budget (OMB) approved the extension for the continued use of the OASIS-D instrument. The new expiration date is November 30, 2024. Providers collecting OASIS on paper may use up any current inventory prior to using the instruments with the updated expiration date. Versions of the OASIS-D Data Set with the updated OMB expiration notice may be found on the CMS Home Health Quality Reporting Program OASIS Data Set webpage found in the Downloads section of the OASIS Data Sets webpage: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/OASIS-Data-Sets
Click Here to register for the on-demand Precision OASIS-D Training through our partnership with the Homecare & Hospice Association of Utah. Individual and Full-Agency Access options are available (12 contact hours or CEUs for PT or OT).
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