Home Health & Hospice Week

Congress will battle over Medicare cuts next month.

While your costs are going up, your Medicare payment rates are likely to go down next year--unless you can sway some influential lawmakers to your side.

The U.S. House of Representatives passed a bill Aug. 1 to reauthorize and expand the State Chil-dren's Health Insurance Program (SCHIP). It wants to pay for the SCHIP spending in part by freezing home health agency rates at 2007 levels for 2008.

On top of the 2.75 percent case mix creep cut the Centers for Medicare & Medicaid Services has proposed in the refinements to the prospective payment system, that will spell big cuts for HHAs overall.

Steep cost: The rate freeze would cut $2.6 billion in Medicare payments to HHAs over five years, notes the National Association for Home Care & Hospice. The cut for case mix creep would strip more than $5 billion from HHA payments in that time period, NAHC warns.

But the rate freeze and case mix creep cut aren't set in stone. The Senate's SCHIP bill passed Aug. 2 has a smaller SCHIP increase, a higher cigarette tax and no Medicare cuts. That configuration may be the compromise House lawmakers eventually agree on to avoid a threatened veto from President Bush.

Or legislators may come to an agreement on the SCHIP items before the program's Sept. 30 expiration and deal with the Medicare issues in a separate year-end omnibus bill, experts predict.

Take action: It's vital for HHAs to contact their elected representatives now to urge them to avoid HHA cuts in final legislation, NAHC stresses. Many legislators are at home over Congress' August break.

Both senators and representatives are circulating letters to leadership urging them not to include the cuts, and the letters need more lawmakers to sign on, NAHC says. • CMS has once again delayed the long-awaited release of the National Provider Identifier database. The NPI query database will be available Sept. 4 and the downloadable file will be available about a week later, CMS says in a message to providers.

The extra time is required to allow providers to edit their own National Plan and Provider Enumeration System (NPPES) data that will be in the database, CMS maintains. Providers have until Aug. 20 to submit their data edits.

CMS originally said it would allow providers by June to look up the NPIs of doctors who refer patients to them, but then the agency delayed the database launch until Aug. 1. • HHAs aren't the only ones taking a beating in PPS changes this year. In its final inpatient PPS rule for hospitals, CMS sets out a 4.8 percent cut staggered over three years for improved coding and documentation. That's changed from the proposed rule's original two-year timeframe [...]