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NAHC Overtime Lawsuit Update: Parties Submit Competing Motions to Court of Appeals

NAHC’s lawsuit challenging the validity of the Department of Labor (DOL) rules regarding minimum wage and overtime compensation for personal care and live-in aides is headed to the Supreme Court. NAHC and the other plaintiffs have filed for a Motion of Stay with the U.S. Court of Appeals that reversed the lower court ruling that had vacated the challenged rules. The U.S. Department of Justice, representing the DOL, has also filed a Motion for Expedited Issuance of Mandate. NAHC says the Court of Appeals decision is expected to take effect on October 13 with an order that the lower court issue a decision in favor of the DOL.

NAHC believes the Motion for Stay is a key step in the appeal to the Supreme Court. If it is not granted, the rules will go into effect around October 13 even if there is an appeal pending before the Supreme Court. If the Court of Appeals denies the stay request, NAHC intends to seek a stay through the Supreme Court.

In its Motion, NAHC and the co-plaintiffs argue that a stay is necessary to protect the interests of consumers, workers, home care businesses, and state Medicaid programs. If the Court of Appeals ruling goes into effect, plaintiffs argue that consumers will face access to care problems, loss of continuity of care with the workforce shifting to part-time employees, and the risk that quality of care deteriorates when multiple caregivers replace a single one with a patient.

Click here to read more from NAHC.


NAHC Video Now Available: Reception Honoring 50th Anniversary Of Medicare & Medicaid

On July 30, 2015, the Leadership Council of Aging Organizations (LCAO), including NAHC, held a reception honoring the 50th Anniversary of Medicare, Medicaid and the Older Americans Act.

Click here to see NAHC’s video of the reception.

 


CMS Announces Value-Based Insurance Design Model To Improve Care & Reduce Costs In Medicare Advantage Plans

CMS announced that the Medicare Advantage Value-Based Insurance Design Model, which will test the hypothesis that giving Medicare Advantage plans flexibility to offer targeted extra supplemental benefits or reduced cost sharing to enrollees who have specified chronic conditions can lead to higher-quality and more cost-efficient care. The model will also help health plans and consumers have the necessary tools to improve costs and spend dollars more wisely.

The overall goal of the model is to improve beneficiary health, reduce the utilization of avoidable high-cost care, and reduce costs for plans, beneficiaries and the Medicare program. This model focuses on Medicare Advantage enrollees with chronic conditions, such as diabetes, congestive heart failure, chronic obstructive pulmonary diseases (COPD), and hypertension.

Click here to read more from CMS.


Occupancy Rates Down, Cash-On-Hand Increases In SNFs

According to a new report, there has been a decline in occupancy rates and an increase in days cash-on-hand in skilled nursing facilities (SNFs). SNFs saw a decrease in occupancy rates from 91.9% in 2010 to 90.4% in 2014. The decrease may be traced to shorter stays due to the increase in use of SNF alternatives, such as home and community services and changes in hospital referral patterns.

Moreover, days cash-on hand, which refers to a facility’s liquidity, increased from 36.2 days in 2010 to 45.7 days in 2014, a modest boost, which may be the result of increases in operating margins. The report found total earnings before interest, taxes, depreciation, and amortization increased from 6.2% to 6.4% between 2010 and 2014.

The report detailed the forces driving trends in the SNF industry, including accountable care organizations, bundled payments, and the shift from volume-based to value-based reimbursement.

Click here to read more.


NAHC Meets With CBO On Care Planning Improvement Act

NAHC has recently met with officials from the Congressional Budget Office (CBO) to discuss the potential cost savings implications of the Home Health Care Planning Improvement Act of 2015 (HR 1342/S578). The bill would allow non-physician practitioners (NPP), including Nurse Practitioners, Physicians Assistants, Clinical Nurse Specialists, and Nurse Midwives to certify Medicare home health services comparable to physicians. The home care community welcomes this change as more patients have NPP’s as their primary care source.

The progress of federal legislation may be hindered or blocked because CBO “scores” a bill as having a cost that is not offset by other savings or revenue. Often times, legislation is blocked simply because CBO has not scored the bill due to other priorities. A number of congressional offices and committees have pushed to have HR 1342/S578 scored to no avail in the past years. The bill is now under review at the CBO, which is positive progress, according to NAHC.

CBO has expressed interest in learning about the bill and what the potential changes in care patterns and Medicare spending might be triggered by the legislation if it was enacted. NAHC and other proponents of the bill have emphasized that the bill would remove an impediment to direct clinical integration and communication between home health care and the patient’s primary medical practitioner. Furthermore, NAHC has explained that Medicare could achieve savings through the legislation as it would shift physician billings to NPP billings that are reimbursed at the lower rate of 85% of the physician payment rates for certain items.

At this time, however, when and how the CBO will score the bill is unknown. NAHC encourages everyone to connect with their congressional delegation with a request that they all cosponsor the pending bills in the House and Senate.

Click here to read more.