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CMS Approves Non-Skilled Home Care Benefit in Medicare Advantage

Posted on Wednesday, February 7, 2018 12:58 PM

CMS announced last week that non-skilled care will be included in the Medicare Advantage plan starting in 2019 as a supplemental benefit. 

The CMS decision is an important change to supplemental benefit because it allows payers to cover services like non-skilled in-home support for daily maintenance and activities, which is a first. CMS will also include portable wheelchair ramps and other assistive devices and modifications, as necessary, in the supplemental benefit. These benefits are meant ameliorate the damage caused by physical injuries and ailments and prevent hospitalization or re-hospitalization.

CMS has previously not allowed an item or service to be eligible as a supplemental benefit if the primary purpose included daily maintenance. Under the new policy, CMS would allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.

Source: NAHC Report


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