Medicare Compliance & Reimbursement

Despite the vocal support of many members of Congress, it appears there will be no reimbursement relief forthcoming for home health agencies this year.

Many HHAs already had given up on the idea of relief from the 15-percent cut. But they had hoped a provision passed by the Senate, calling for a 5-percent add-on for rural patients until Sept. 30, would take up where the 10-percent rural addon leaves off come April 1.

But the Senate provision wasn’t picked up in the omnibus appropriations bill negotiated be tween the House and Senate. While physicians and rural hospitals will secure additional funds, HHAs have been left out in the cold.

Many congressmen voiced their support for home health relief and home care lobbyists had been receiving “all the right signals” that the modest rural add-on would pass, says one insider. But key leadership opposed any help for HHAs in light of the General Accounting Office and Medicare Payment Advisory Commission claims that agencies are being paid much more than their costs for Medicare patients.

“[House Ways and Means Chairman] Bill Thomas fought the home health rural add-on and won,” one lobbyist laments. Members of Congress including Thomas (R-CA) continually pointed to the damning GAO and MedPAC figures as the reason.

The fact that the rural add-on provision affects only a small subset of an already small provider group means the “volume of noise” on this issue wasn’t exactly deafening, says one trade association representative.

So most home care providers will turn their eyes to 2004 developments, including President Bush’s plan for Medicare modernization that might include a $10 copayment for home health services. Factions in both houses of Congress are at work on their versions of Medicare reform.