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Home Health & Hospice Week

Legislation:

See Your Future In Current Legislation

Published on Sun Jul 20, 2003

Lawmakers in Washington DC have your fate in their hands, but the final legislation is still up in the air.

Language affecting home care providers is contained in the Medicare prescription drug bills in the Senate and House. "The Medicare changes Congress is making today, tomorrow and over the coming weeks will mean significant changes in your reimbursement," warns Warren Hebert of the Home Care Association of Louisiana. For example, "if we have a co-pay, you will likely experience a major reduction in the number of beneficiaries accessing home care."

Here are some of the top provisions that will most affect home care providers - good or bad:

HHAs

  • 5 percent add-on for rural home health agencies for limited periods. (Senate and House)

  • 0.5 percent reduction to HHAs' inflation updates from 2004 through 2006. (House)

  • co-pay of 1.5 percent of the national average episode payment - exceptions are proposed for low-income beneficiaries. (House)

  • suspension of OASIS collection for non-Medicare, non-Medicaid patients. (House)

    DME

  • three-year phase-in of competitive bidding for all durable medical equipment, DME-related supplies, off-the-shelf orthotics, parenteral nutrition and supplies, and nebulizer and infusion drugs. The bill would exempt rural and urban areas with a low population density. (House)

  • seven-year freeze to inflation updates for DME. (Senate)

  • reduction to 85 percent of average wholesale price for drugs. However, separate payments for nebulizer and infusion drug administration would be allowed under Medicare, notes the American Association for Homecare. (Senate)

  • quality standards. (Senate and House)

    Holiday Deadline Expected

    Other provisions in the House legislation include a new Medicare Payment Advisory Commission study of home health profit margins, a disease management program, payment for hospice consultations and regulatory reforms.

    Both House and Senate leadership express hopes that they'll wrap up action on the Medicare prescription drug bills and their accompanying provisions by the July 4th recess.

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