Home Health & Hospice Week

As lawmakers in Washington, D.C. continue to battle over the health care reform package, home care providers are working hard to keep the fallout from harming them and their patients.

Senate and House leaders are laboring behind closed doors to hammer out the differences in their health care reform bills. Both bills contain tens of billions of dollars in Medicare home care cuts, although the Senate's version is slightly less drastic (see Eli's HCW, Vol. XIX, No. 2, p. 14).

Thirty-two senators sent a Jan. 11 letter to Senate Democratic leaders urging them to keep the more favorable Senate home health agency provisions in the eventual health reform compromise bill. The Senate version "targets fraud and abuse in the home health industry and spreads the payment reductions over a longer period of time to allow providers to adjust to payment changes," the letter says, according to the National Association for Home Care & Hospice.

The House cuts to home care would "represents a disproportionate sacrifice for the home health community" and "would negatively affect access to care in the home setting," the letter continues. Supplier stake: In addition to the HHA and hospice cuts, Congress is considering a new tax for home medical equipment manufacturers, notes the American Association for Homecare. "The House and Senate medical device tax proposals will have a disproportionately negative impact on manufacturers of devices that allow patients to recover from illness or that facilitate their ability to remain in their homes," the trade group notes.

Such a tax will result in loss of American jobs and harm to the industry and its patients, AAHomecare's TylerWilson says in a message to manufacturers. "HME is utilized by patients who are predominately covered by federal government programs," he notes. "An expansion of health care coverage will not significantly increase HME spending or result in windfall profits to HME manufacturers" to cancel out this tax.

Whether Congress settles on the medical device tax and other home care cuts may depend on the larger issues under debate. If lawmakers decide to fund reform with a tax on married couples with higher-bracket incomes, they will need to find less other funding than if they choose to go with the tax on the so-called "Cadillac" insurance plans. Many other factors are also in play that will raise or lower the need for other reform funding, depending on what the final reform bill includes.

More bad publicity: Home care providers' fight to keep punishing cuts out of the final reform package keeps getting tougher. The mainstream press continues to highlight the fraudulent home care schemes taking place in South Florida and other areas of the country.

For example: "NBC Nightly News" profiled an FBI agent and HHS Office of Inspector General agent making a visit to an HME supplier suspected of fraud. Lawmakers estimate $60 billion a year is lost to Medicare fraud, the "News" said.

Medicare fraudsters used to bill $1 million at a time in scams, an unnamed Department of Justice prosecutor told the "News." Now they bill $30 million to $50 million before being caught.

The Medicare theft problem is "huge, it's like an epidemic," said OIG agent Julie Rivera. "They're just bleeding the system and as long as Medicare keeps paying out the money they're just going to keep committing the fraud."