Recent Legislative Activity
Stop the Rollout of the Home Health Groupings Model (HHGM)
As part of the proposed CY2018 Home Health Prospective Payment System, the Centers for Medicare and Medicaid Services (CMS) has proposed a massive shift from the traditional home health episode to HHGM. The proposed HHGM methodology and payment model, effective January 1, 2019, represents a radical shift in how home health services are reimbursed, using an entirely new and significantly different case mix model focused on patient characteristics. Most alarming, this radical change has been modeled only on paper and has never been tested by any agency in any area of the country.
S. 445/H.R. 1825: Home Health Care Planning Improvement Act
This bipartisan legislation would amend the Medicare law to allow advanced practice nurses (APRNs) – a group that includes nurse practitioners, clinical nurse specialists and certified nurse midwives – certify eligibility for Medicare beneficiaries and make changes to home health plans of treatment.
Sponsors: Sen. Susan Collins (R-ME), Sen. Ben Cardin (D-MD), Rep. Chris Collins (R-NY), Rep. Jan Schakowsky
H.R. 2663: Home Documentation and Program Improvement Act
This bipartisan legislation would require Medicare to consult a home health agency’s patient record as supporting material to the documentation in the medical record of the physician certifying for home health services. The goal of doing so is to reduce the amount of home health claims denied as a result insufficient documentation in the certifying physician’s patient record. Additionally, H.R. 2663 would provide home health agencies, who are eligible administrative appeal, with the option to enter into a settlement for an amount determined by the Secretary of Health and Human Services.
Sponsors: Rep. Kenny Marchant (R-TX), Rep. Earl Blumenauer (D-OR)
S. 353: Preserve Access to Medicare Rural Home Health Services Act
This bill will extend the 3 percent rural add-on for Medicare home health services through December 2022. This payment modifier ensures rural agencies, which face higher overhead expenses, will be able to keep their doors open and provide necessary care to homebound patients in rural areas.
Sponsors: Sen. Susan Collins (R-ME), Sen. Maria Cantwell (D-WA)
S. 693/H.R. 1676: Palliative Care & Hospice Education and Training Act (PCHETA)
This legislation would establish education centers and career incentive awards to improve the training of doctors, nurses, physician assistants, social workers and other health professionals in palliative care.
Sponsors: Sen. Shelley Moore Capito (R-WV), Sen. Tammy Baldwin (D-WI), Rep. Tom Reed (R-NY), Rep. Eliot Engel (D-NY)
S. 1334 / H.R. 2797: Patient Choice and Quality Care Act
This legislation would test models of care and provide new grants to promote education about advance care planning. Additionally, this bill would strengthen the documentation of advance directives and portable treatment orders by hospitals, skilled nursing facilities, home health agencies, and hospice programs, and create standards for incorporating advance care planning documents into electronic health records.
Sponsors: Sen. Johnny Isakson (R-GA), Sen. Mark Warner (D-VA), Rep. Phil Roe (R-TN), Rep. Earl Blumenauer (D-OR)