Dr. Landers Leads Alliance Advocacy on Home Health Cuts, Hospice SFP
The National Alliance for Care at Home is focused like a laser on the two big advocacy priorities — the looming payment cuts to home health care and the Medicare hospice Special Focus Program (SFP) — Alliance CEO Dr. Steven Landers told a gathering of journalists in a media briefing on November 21, 2024.
“The world around us, our public policy arena, is looking toward 2025 and the future,” Steve Landers, MD, chief executive officer of the Alliance, said Thursday during a press conference. “We have President Trump coming back into the White House and his new administration, we’ve got some changes in Congress coming up next year. But I want to make sure our community knows that we’re actually not done with 2024 yet. We’ve got a lot that we are trying to accomplish right now, this year.”
HOME HEALTH PAYMENT CUTS
“I can’t emphasize enough how important it is that Congress intervene and stop the home health payment cuts that have been brought forward by the new Patient-Driven Groupings Model,” Landers said. “As a physician and advocate for patients, it bothers me that the thing is even called patient-driven, because what this has been is a massive cut and a decimation of benefits, reducing access to care in vulnerable communities. … That’s not patient-driven, that’s bad policy.”
The Alliance is working with Sens. Debbie Stabenow (D-MI) and Susan Collins (R-ME) to solve home health providers’ reimbursement challenges with legislation. The two senators notably introduced the Preserving Access to Home Health Act, which would bar CMS from imposing rate cuts based on the shift to PDGM.
“Thank God for Senators Stabenow and Collins,” Landers said. “We’re with them trying to figure out how to get this fixed, or at the very least get this delayed.”
HOSPICE SFP
“We think that [the CMS] methodology [for the SFP] is likely flawed. It is likely to harm beneficiaries if it’s released, because it’s going to steer people away potentially from quality providers,” Landers said in a press briefing on Thursday. “It might make them even fearful about hospice care, which is the last thing we want to see happen. At the same time, [CMS’] implementation misses likely lots of truly poor performing hospices that should be called out and addressed.” …
CMS will also make public the names of hospices selected for the SFP, putting a “Scarlet Letter” on providers who may be in the program as a result of flawed data, according to Landers.
“We are asking CMS to not release the list that they’ve been developing, because as part of the special focus program they’re instructed to develop a list of the 10% poorest quality hospices,” Landers said. …
“It’s not being implemented consistent with how Congress envisioned it,” Landers said. “The very people that were involved with the legislation to start the Special Focus Program in the first place are with us, locked arm in arm to try to fix this. It’s not what they envisioned when this law was written.”
HOME HEALTH “CLAWBACKS”
The clawbacks, are an attempt from the U.S. Centers for Medicare & Medicaid Services (CMS) to recover perceived overpayments from home health providers in relation to the shift to PDGM.
“It’s a terrible thing to have in front of us, because it’s already been difficult,” Dr. Steve Landers, CEO of the National Alliance for Care at Home, said during a media briefing on Thursday. “To think that there’s billions of more dollars to come — it’s really unthinkable.”
“CMS has, once again, said they are not going to collect on that adjustment at this point in time,” William A. Dombi, president emeritus and counsel, at the National Alliance for Care at Home, said during a webinar presentation earlier this month. “They’ve not published any kind of schedule, or even criteria for determining a schedule. As this debt grows, we begin to wonder whether it will ever be capable of being collected without decimating the home health benefit under the Medicare program.”
“The only good news is,” said Landers, “I think, there must be some realization somewhere that they’ve gone too far, and that they have harmed people, and that going even further would be destabilizing, even beyond what we’re already seeing,” he said during the briefing.
