In The News

Democrats Look at Lowering Medicare Eligibility Age in Healthcare Package

Wall Street Journal/March 30, 2021, By Stephanie Armour and Kristina Peterson

WASHINGTON—Congressional Democrats and the Biden administration are planning another round of healthcare initiatives that could include lowering the Medicare eligibility age, following their major expansion of the Affordable Care Act this year.
Democrats are still negotiating over which healthcare policy elements could be in the second of two spending programs the administration plans to unveil soon, according to congressional aides and industry groups.
The package is likely to contain measures to reduce drug prices and expand health coverage, lawmakers said. Proposals to expand Medicare eligibility from age 65 to 60 and to enable the federal government to negotiate drug prices in the health program for seniors—both of which President Biden supported on the campaign trail—are also likely to be included.
“We should lower the eligibility age for Medicare from 65 down to 60. There are many millions of seniors who would be very, very grateful if we did that right now,” Senate Budget Committee Chairman Bernie Sanders (I., Vt.) said Monday. He also said he hoped to expand Medicare to cover dental care, hearing aids and eyeglasses, and to pay for those through savings from reduced drug prices for Medicare.
The healthcare proposals would face opposition from many Republicans and hospital groups, who say they could reduce the labor force because more people may retire early. Republicans also say they are reluctant to add to the nation’s $3 trillion budget deficit and that Medicare’s trust funds are already facing insolvency in coming years…

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CMS Holds Claims With Expectation Congress Will Avert Sequester Cuts

Inside Health Policy
By Michelle M. Stein / March 30, 2021 at 6:08 PM
CMS will hold Medicare claims “for a short period” after April 1 so that providers don’t see the 2% Medicare sequestration cuts go into effect before lawmakers take final action to extend the moratorium on those cuts.
“In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, we instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow,” CMS said in a March 30 Medicare Learning Network announcement. “This will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary.”
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Biden Jobs Plan Would Invest Billions In Care Economy, Grow Home Care

Inside Health Policy
By Maya Goldman / March 31, 2021 at 5:00 AM
President Joe Biden’s American Jobs Plan would extend the Money Follows the Person program to expand access to home- and community-based care, according to briefing notes released by the Biden administration Tuesday night (March 30). As of press time, the White House had not responded to questions about how long the extension would last.
The plan [unveiled by Biden Wednesday, March 31] would invest $400 billion in the so-called care economy. An administration official said the plan would reduce waitlists for home care, and, in doing so, create more jobs in the home care workforce.
One in six essential health care workers live in poverty, the official said. Biden’s plan would create more than 1 million new jobs in the care industry, and ensure those jobs pay well. The official did not specify whether all of those jobs would be in home care.
The official said the president’s team has been in touch with members of Congress to get feedback and figure out how to proceed but did not say that reconciliation has been identified as a way to push the plan through.

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Colorado Medicaid Home Health & Private Duty Nursing Increase Approved! 

In a last minute motion, prior to finalizing the budget package, the Joint Budget Committee (JBC) approved a targeted increase of $7 million to be split evenly between skilled home health and private duty nursing rates. This increase is in addition to the 2.5% "across the board" provider rate increase that was approved. The introduced FY2021-22 Long Bill will contain the following increases:

Home Health: +7.3% (brings Medicaid from 73% to 80% of LUPA rates)

PDN - LPN: +10.5%

PDN - RN: +5.6%

See the attached rate schedule which reflects the rate increases. 

Of note, these were the only targeted rate increases approved by the JBC. This win for Colorado Home Health and Private Duty Nursing agencies is a great example of your HHAC membership at work. Your voices and support DO make a difference! Thank you to HHAC's Lobbyist and Government Relations group, and to our Legislators for their support of the homecare industry and those we care for. 

Please visit the 2021 JBC website page to send a thank you email to each of the six Committee Members. 

As an added bonus, the legislature included funding for a free year of car washes and Starbucks for all homecare workers ... April Fools! Sorry, we couldn't resist. The information about the rate increases is no joke, however. Great work! 


CMS Alert: New Frequently Asked Questions Document Posted for the Hospice Benefit Component of the Value-Based Insurance Design Model

The Center for Medicare and Medicaid Innovation (Innovation Center) is pleased to announce a new Frequently Asked Questions (FAQ) document as an additional resource for the Value-Based Insurance Design (VBID) Model’s Hospice Benefit Component. This FAQ document can be found on the Model website and provides answers to questions on claims and billing, networks and contracting, appeals and grievances, and other topics related to the Hospice Benefit Component.

The FAQ document is an addition to other resources on the Hospice Benefit Component, including:

  • Hospice provider-friendly webpages with details on coverage, claims and billing, and participating plans found here
  • Hospice Provider Checklist found here
  • Calendar Year (CY) 2021 VBID-Hospice Benefit Component Technical and Operational Guidance found here
  • VBID-Hospice Benefit Component Technical Support webinar sessions, with recordings, slides, and transcripts here
  • CY 2021 VBID-Hospice Benefit Component Monitoring Guidelines here

We encourage you to monitor the VBID Model webpage for future updates. Please contact our help desk with any questions/comments at [email protected].

For background, the Hospice Benefit Component of the VBID Model is testing the impact on quality and program expenditures of incorporating the Medicare Part A hospice benefit into the Medicare Advantage (MA) program for Part A and Part B services, with the goal of creating a seamless continuum of care. In voluntarily participating in this Model Component, MA Organizations are incorporating the Medicare hospice benefit into MA covered benefits while offering comprehensive palliative care services outside the hospice benefit for enrollees with serious illness.

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