Home Health & Hospice Week

CMS head pick contains more question marks.

Whether the Trump Administration benefits or harms home care providers remains to be seen, but President-Elect Trump’s pick for HHS leader is encouraging.

On Nov. 29, Trump announced Rep. Tom Price (R-Ga.) as his nominee for Department of Health and Human Services Secretary and consultant Seema Verma as his pick for Centers for Medicare & Medicaid Services Administrator.

Price, a practicing orthopedic surgeon for 20 years before entering politics, has sided with home health agencies over the Pre-Claim Review demonstration. In May, Price spearheaded a letter signed by 116 members of Congress urging CMS to withdraw PCR (see Eli’s HCW, Vol. XXV, No. 22). In a Sept. 7 House Ways and Means Health Subcommittee hearing on quality in Medicare Part A, Price questioned Almost Family President Steve Guenthner about PCR and raised the idea of a PCR delay and reform of face-to-face requirements. He also questioned the Home Health Value-Based Purchasing withhold level that will reach 8 percent, when other provider types’ VBP withhold levels are capped much lower at 1 or 2 percent (see Eli’s HCW, Vol. XXV, No. 34) And later that month he introduced, along with Rep. James McGovern (D-Mass.), the Pre-Claim Undermines Seniors’ Health (PUSH) Act that called for imposing a one-year moratorium on PCR in all demonstration states and requiring CMS to report to Congress on PCR’s impact on patients, home health agencies, physicians, and Medicare spending (see Eli’s HCW, Vol. XXV, No. 36).

In light of those actions, the Visiting Nurse Associations of America “is grateful to Rep. Price for his strong advocacy on behalf of home-based care,” says VNAA’s Joy Cameron.

The National Association for Home Care & Hospice calls Price “a staunch supporter of home care.” NAHC’s Val Halamandaris says, “We look forward to working with Dr. Price in his capacity as Secretary of the U.S. Department of Health and Human Services. He has a deep understanding of the value of home care and hospice that we expect will be key to his actions with Medicare and Medicaid.”

The trade group for Price’s home state has more praise for the lawmaker. “We have worked closely with Congressman Price since he was elected and he is a huge home care advocate and supporter of children’s health care issues on the Republican side of the aisle,” says Judy Adams of the Georgia Association for Home Health Agencies. “We are thrilled with his nomination and know that he will always be a true champion of patients and their families. As Secretary of HHS we know that Congressman Price will work tirelessly to ensure that all patients get the care they so richly deserve,” Adams tells Eli.

CMS Administrator May Value Home Care

CMS Administrator nominee Verma is less of a known quantity. Her nomination appears to be related to Vice President-Elect Mike Pence, with whom she worked as a consultant on Indiana’s Medicaid revamp known as HIP 2.0. Verma, who has an MPH from Johns Hopkins University, has also worked with other states on adding Medicaid program requirements such as beneficiary cost-sharing and lock-outs for failing to pay premiums.

The pick could be an encouraging signal for home care, suggests attorney Robert Markette Jr. with Hall Render in Indianapolis. “Her nomination may tell us more about the future of Medicare overall,” Markette tells Eli. “In Indiana under Pence … we have seen the Medicaid administration much more interested in home health and home- and community-based services. They see it as a cost effective solution and have really been looking at expanding money to home- and community-based services as well as redesigning our state Medicaid reimbursement model to provide better reimbursement.”

“I don’t know how that will translate going forward, but I am optimistic,” Markette adds.