Home Health & Hospice Week

Reps call for relief.

Your Medicare payment rates changed as of April 1, and not for the usual reasons. Instead of a routine payment update or similar, Medicare is now reimposing sequestration cuts — although not all at once.

“On December 10, 2021, the Protecting Medicare and American Farmers from Sequester Cuts Act was passed and impacts payment for all Medicare Fee-for-Service (FFS) claims,” HHH Medicare Administrative Contractor CGS reviews in a new post on its website. There was no sequestration payment adjustment through March 31, 2022, a 1 percent payment adjustment from April 1 to June 30, 2022, and a 2 percent payment adjustment beginning July 1, 2022, the MAC recounts.

Just to be clear: Those “adjustments” are cuts. The 1 percent decrease is “applied to all Medicare FFS claims with a date of service / ‘through’ date of service on or after April 1, 2022,” CGS explains. The cut is “calculated after the approved amount is determined and the deductible and coinsurance are applied,” the MAC elaborates.

“For claims with DOS that span April 1, 2022 (e.g., 031522 – 041522), the approved amount is determined based on the entire claim (not DOS on or after April 1 only),” CGS adds.

Meanwhile, the National Hospice and Palliative Care Organization is appealing to lawmakers to change the reductions. “Today, Congress is leaving town for a two-week vacation without addressing the cuts to hospice,” NHPCO blasted in a release. “Due to congressional inaction, [the sequestration cut] went into effect on April 1 amidst an ongoing Public Health Emergency, a shortage of health care workers, and historic inflation — none of which were accounted for when the sequestration requirement as put into place more than a decade ago,” the trade group said.

“This cut will have a major impact on access to care, especially in rural and underserved communities,” NHPCO warned. “This is a direct attack on access to the care that Medicare promises seriously ill beneficiaries.”

“Congress found an additional $200 billion dollars to spend above last year’s appropriations, but they ignore the plight of hospices struggling to keep their doors open with skyrocketing inflation and a health worker shortage,” NHPCO CEO Edo Banach said in the release. “Once again, our seniors and those with life-limiting illnesses get the short end of the stick.”