Legislative Update: October 1, 2019

Congressional Update
Having passed a short-term spending bill to prevent a government shutdown on October 1, Congress is recessing for the first two weeks of October. 
The short-term continuing resolution (CR) funds federal programs through November 21. The House already has passed 10 of the 12 spending measures for 2020, including those covering senior housing and services programs. However, the House bills are based on a higher total spending limit than allowed under the budget deal Congress and the President reached in July. Funding levels for specific programs therefore still will be subject to discussion between the House and Senate in finalizing fiscal 2020 appropriations.
Work Continues on Behavioral Adjustments
Home health stakeholders including ElevatingHome/VNAA and LeadingAge are drafting a joint letter to the House Ways and Means Committee and Senate Finance Committee supporting the passage of the Home Health Payment Innovation Act of 2019 (H.R. 2573/S.433) to prevent the 8% rate reduction due to behavior assumptions. There are encouraging signs as 20 additional cosponsors were added to the House bill and 2 additional cosponsors on the Senate bill. It is critical to continue to express your support for this legislation to pass before the end of the year.
The legislation will improve the planned changes to the Patient-Driven Payment Model (PDGM) by prohibiting CMS from reducing payment for Medicare home health services based on faulty, presumptive assumptions before they go into effect in 2020. It would require the use of evidence to make payment changes – allowing for a more accurate reimbursement system that better aligns payment with patient care needs.
Hospice Assessment and Quality Measurement
With the ongoing development work on the HOPE (Hospice Outcome & Patient Evaluation) instrument, we are continuing engagements with CMS and Abt Associates, the CMS contractor, around design and implementation issues. A nomination was submitted for representation on the upcoming technical expert panel to provide input on an assessment instrument and corresponding quality measures for hospice care with work scheduled to begin in early November.
As a result of the Department of Health and Human Services Office of Inspector General’s reports on vulnerabilities in hospice care, we have been asked to provide our input to Congressional policymakers as they work on developing a potential legislative response to the reports. We support this effort to strengthen current requirements for reporting abuse and neglect, stronger CMS oversight of state survey agencies, and improved mechanisms for consumers to gain information on hospices and to also resolve issues with quality of care.

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