CMS Removes HHGM Proposal from Final 2018 Rule

Submitted by David Totaro, Chief Government Affairs Officer (GAO)

Our voices were heard. Thank you and high five to all of our BAYADA office and field employees who recently took action to voice concern about the federal Home Health Groupings Model (HHGM) proposal, which would have resulted in revenue reductions between 4.3% and 17% for BAYADA’s Home Health Specialty Practice. Such significant reductions would have impacted not only Home Health, but BAYADA as a whole.

Yesterday afternoon, the Centers for Medicare and Medicaid Services (CMS) formally indicated that 2018’s Payment Rule does not include the HHGM proposal. CMS indicated that it could not finalize the HHGM proposal at this time based on the comments received on the issue.

BAYADA employees sent more than 3,000 messages to members of Congress urging representatives and senators to take a stand against HHGM. BAYADA joined industry-wide action led by an unprecedented coordinated effort by the Partnership for Quality Home Health Care, Elevating Home and the National Association for Home Care and Hospice (NAHC). This effort spurred 50 US senators and 179 US representatives to reach out to CMS and the US Department of Health and Human Services (HHS) to caution against finalizing HHGM. Through BAYADA’s action on this issue and previous calls to action, BAYADA has shown itself to be one of the strongest advocacy teams in our industry.

While delaying the HHGM proposal does not indicate a permanent withdrawal, it is a clear victory for the home health and home care communities that took immediate action to stop the rule from becoming final. BAYADA and other industry stakeholders will continue to work with CMS to improve the payment model, including participating in discussions with the Congressional Committee on Ways and Means to finalize a potential legislative proposal.

Thank you for your reliability and your dedication to advocating on behalf of our staff and clients.

 

Making The Rounds in North Carolina

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

BAYADA Chief Government Affairs Officer Dave Totaro and I met with key lawmakers this past week, seeking their support for a rate increase for aide services under three Medicaid programs – Personal Care Services, Community Alternatives Program for Disabled Adults (CAP-DA), and CAP for Children (CAP-C)- in two different settings: in-home care and adult care homes.  While the lift is heavy, $47.8 million to bring the rate from $13.88 to $17.00 over two years, our conversations were positive.  We also met with the newly appointed but not yet confirmed Secretary of Health & Human Services, Dr. Mandy Cohen.  A good round of meetings!

""
Dave Totaro, Lee and Dobson Rep. Carla Cunningham, who is a nurse

PA Governor Tom Wolf Announces Plan to Consolidate Departments Crucial to Home Care

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

During Governor Tom Wolf’s budget address, he proposed consolidating the Department of Human Services (formerly known as the Department of Public Welfare) the Department of Aging, the Department of Health, and the Department of Drug & Alcohol Programs.  If the consolidation goes through it will be called the PA Department of Health & Human Services.  It will also be one of the largest state agencies in the United States.  There are concerns by many advocacy groups that this could lead to additional bureaucracy and more items getting “lost in the shuffle”.  Wolf claims the consolidation will lead to seniors and disabled individuals having greater support and coordination of benefits.  BAYADA’s Government Affairs Office (GAO) will continue to track this proposal and evaluate the impact.  To read the full announcement click here.

NC Department of Health & Human Services (DHHS) Secretary Announced

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

Dr. Mandy Cohen has been appointed by NC Governor Roy Cooper as the new Department of Health & Human Services Secretary to lead Medicaid.  Cohen, an internist, carries a wealth of experience and knowledge having recently served as the Chief Operating Officer and Chief of Staff for the Centers for Medicare & Medicaid Services in Baltimore.  She plans to partner with healthcare providers, consumers, regulators, and lawmakers for a healthier state. BAYADA submitted formal comments on four Medicaid clinical policies.  Special thanks to the division director review teams for their insight and guidance in drafting these recommendations.

Caption: Dr. Mandy Cohen

North Carolina: We’re Off To The Races

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

Lawmakers return to Raleigh, NC for the start of the 2017-2019 legislative session on January 11.  We expect to see a few changes in committee assignments and leadership, especially in House Appropriations for Health & Human Services (HHS), with the election defeat of Representative Marilyn Avila.  However, we anticipate (and are thrilled) that Representative Nelson Dollar will remain Chair of HHS Appropriations and Representative Josh Dobson will assume the leadership position of vice-chair on that committee.  Senators Ralph Hise and Louis Pate will remain Co-Chairs of Senate Appropriations for HHS.  Our reimbursement priority is to increase the Medicaid aide rate from $13.88 to $17.00 over two years.