Home Health & Hospice Week

Quick doc fix will mean it's back to the drawing board early next year.

Home health agencies and durable medical equipment suppliers got their Christmas present a week early as Congress passed a Medicare package with no home care cuts.

After intense political maneuvering, the Senate on Dec. 18 unanimously passed a Medicare budget bill that contained a six-month "fix" to the 10 percent cut for Medicare physician rates that was scheduled to begin Jan. 1. Lawmakers paid for the provision with cuts to Medicare Advantage plans, inpatient rehab facilities and the Physician Assistance and Quality Initiative fund, the National Association for Home Care & Hospice explains to members.

The House followed suit Dec. 19, passing the bill 411-3. The President is expected to sign it shortly, notes the American Association for Homecare.

Bullet dodged: Home care providers heaved a sigh of relief, since cuts to HHAs, oxygen suppliers and wheelchair providers looked increasingly likely as budget negotiations wore on.

Congress didn't want to hit HHAs with a "double whammy" this year, notes Kathy Thompson with the Visiting Nurse Associations of America--the 2.75 percent cut for alleged case mix creep plus the freeze on the 3 percent inflation update.

The outcome: HHAs still will see the 2.75 percent decrease take effect Jan. 1, but it will be combated by the 3 percent update to result in an overall 0.25 percent increase. That's better than the 5.75 percent cut that was looking likely, Thompson observes. "It's good news/bad news," Thompson says of the legislation that didn't avert the case mix creep cut.

NAHC "applauds the tremendous efforts put forth by the home care community to advocate with their members of Congress this year," the trade group says. "Our collective efforts have truly made a difference in this about-face on the market basket update."

HME suppliers have "scored at least a temporary victory with respect to oxygen cuts and the elimination of the first-month purchase option for wheelchairs," AAHomecare cheers.

Still: Suppliers are disappointed that the bill doesn't contain any relief on competitive bidding or oxygen equipment transfer changes, AAHomecare points out.

Back to work: Providers won't have much time to savor this victory. Because the stripped-down version of the Medicare bill offers only a six-month fix for physicians, Congress will take up a Medicare package early in 2008, NAHC predicts. The 0.5 percent increase to physician payments expires June 30.

"We can't just celebrate and relax for a year," Thompson cautions. HHAs must stay wary of proposed mid-year rates changes, or even retroactive rate changes, next summer.

Watch out: Issues such as the Medicare Payment Advisory Commission's pending rate freeze recommendation and the presidential election year may stack the deck against providers next session, NAHC warns. "Home health will need to remain vigilant [...]