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New Senate Bill Seeks to Loosen Homebound Requirements for Home Health Services

Posted on Monday, October 8, 2018 12:36 PM

The home health industry has made more progress in Washington, D.C., in its effort to reshape certain parts of the Patient-Driven Groupings Model (PDGM).

Sens. Susan Collins (R-Maine), Bill Nelson (D-Fla.) and Debbie Stabenow (D-Mich.) introduced the Home Health Payment Innovation Act — S. 3545 — on Wednesday, October 3rd. If passed, the bill would amend the Social Security Act and loosen a homebound requirement for Medicare beneficiaries in Medicare Advantage plans.

This bill — along with others introduced over the last month, including H.R. 6932 and S. 3458 — is another effort on Capital Hill to mold proposed home health payment reform from the Centers for Medicare & Medicaid Services (CMS).

CMS released details of PDGM in July of 2018. In its initial announcement, CMS highlighted how PDGM is meant to better align reimbursement with patient needs beginning Jan. 1, 2020.

Many home health leaders have been speaking out on issues within the rule, including behavior-based payment changes based on assumptions by CMS.  S. 3545 would require a more data drive approach to payment changes by requiring changes to be grounded in evidence.

“S. 3545 would help to ensure greater stability in the new home health payment model … This is a data driven approach, consistent to what CMS is doing with the skilled nursing facility new payment system — and is a more responsible, evidence-based way to transition to a new payment model,” said  Keith Myers, CEO of LHC Group (Nasdaq: LHCG) and chairman of The Partnership for Quality Home Healthcare, told Home Health Care News via email. “S. 3545 also includes a provision that would permit the waiving of the homebound regulatory requirement … This flexibility is needed and necessary as home health is an important part of keeping patients out of higher levels of care and institutional settings.”

 “Loosening the homebound requirement would enable greater flexibility for the patients we care for, which would improve the quality of care and enhance home health’s ability to participate in new models of care, and Medicare managed care,” Myers said. “It would also allow home health providers to reach those in need of skilled home [health care] services who are currently restricted from receiving home health services because of a strict regulation that limits the capacity of home health to be part of the care of needy Medicare patients.”

The bills have received support from Amedisys (Nasdaq: AMED), the National Association for Home Care & Hospice (NAHC) and others across the industry.

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