Act Now to Extend Mortarium of Sequestration Cuts to Medicare!

PLEASE ACT through the NAHC Advocacy Center!

On March 31, 2021 the suspension of the 2% Medicare sequestration will expire. That means rates of payments will go down 2% beginning April 1. Congress is actively considering legislation that will extend the sequestration suspension. Home health and hospice is an essential service during the ongoing pandemic, with more infected patients under care at home than other settings and patients with higher care needs shifting to home care for safe and effective care. Sequestration will reduce already stressed resources.

The House of Representatives is scheduled to debate H.R. 1868, legislation that would continue the sequestration suspension, on Tuesday, March 16. That bill would also avoid a 4% Medicare rate cut that is triggered by the recently passed Covid stimulus legislation.

SEND A MESSAGE TO CONGRESS RIGHT NOW!

Special BKD CPAs & Advisors Colorado Data Reports for HHAC Members 

Members Click Here to access special Home Health and Hospice Data Reports

President Signs $1.9 Trillion COVID-19 Relief Package

On March 11, 2021, President Biden signed H.R. 1319, the American Rescue Plan Act of 2021 (ARP), a more than 600-page coronavirus relief package that provides $1.9 trillion in spending. The law was passed using budget reconciliation which required 51 votes for passage in the Senate. The legislation includes economic assistance programs related to the COVID-19 PHE and includes the following homecare and hospice related provisions:

1.   The ARP provides for a 10% one year increase in funding for the Federal Medical Assistance Program (FMAP), the federal share of Medicaid, beginning on April 1^st. Funds are specifically designated for Home & Community Based Services and may be applied towards:

• Home Health Care services
• Personal care services
• PACE services
• HCBS Services
• Case Management services
• Rehab services

2.   A Rural Provider Relief Fund Allocation of $8.5 billion has been allocated for rural providers. The original draft of the legislation limited this provision to providers located in rural areas, but now includes providers that may be located in urban areas, but serve patients in rural areas.

3.   $12.2 billion has been provided to increase vaccination supplies and distribution capacity designed to speed up vaccine administration. These provisions will prove very helpful to home care and hospice providers and to their clients/patients in coming days.

4.   The ARP allocates $140 million to support healthcare providers’ mental health and emotional well-being.

While we are grateful to Congress and the President for the support of home care and hospice beneficiaries and those who provider their care, more action is needed, including further suspension of the Medicare sequester and passage of the long-anticipated HEAT Act that would provide for telehealth reimbursement in home health. We also look forward to the momentum building behind the National Association for Home Care & Hospice’s call for “Choose Home” legislation that would create an enhanced home health benefit, serving as an alternative to the skilled nursing facility benefit.

It is anticipated that the House will vote on an extension of the Medicare sequester moratorium during the week of March 15th, prior to its scheduled expiration on March 31^st. The National Hospice & Palliative Care Organization has prepared the following link to Ask your federal legislators to support the Medicare Sequester COVID Moratorium Act (H.R. 315).

CMS Updates Nursing Home Visitation Recommendations

CMS, in collaboration with the CDC, issued updated guidance for nursing homes on March 10^th, to safely expand visitation options during the COVID-19 pandemic public health emergency.

According to the updated guidance, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation for:

• Unvaccinated residents, if the COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated,
• Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated, until they have met the criteria to discontinue transmission-based precautions, or
• Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine

The updated guidance also emphasizes that “compassionate care” visits should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak. Compassionate care visits include visits for a resident whose health has sharply declined or is experiencing a significant change in circumstances.

There is no change in the guidance for health care workers, including hospice workers, and their ability to enter the facility. The guidance states:

Health care workers who are not employees of the facility but provide direct care to the facility’s residents, such as hospice workers, Emergency Medical Services (EMS) personnel, dialysis technicians, laboratory technicians, radiology technicians, social workers, clergy, etc., must be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened.

CMS continues to recommend facilities, residents, and families adhere to the core principles of COVID-19 infection control, including maintaining physical distancing and conducting visits outdoors whenever possible.

Although outbreaks increase the risk of COVID-19 transmission, as long as there is evidence that the outbreak is contained to a single unit or separate area of the facility, visitation can still occur.

More Information:

• Nursing Home Visitation - COVID-19 webpage
• Fact sheet