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  1. Proposed Home Health Rules Harm the Most Vulnerable Beneficiaries
  2. We Called It: Continued Sabotage of the ACA
  3. “Equitable Relief” Ends this Week – Sign Up for Medicare Part B

Proposed Home Health Rules Harm the Most Vulnerable Beneficiaries

In July, CMS proposed new payment, case-mix adjustment and quality reporting rules that will make it harder for individuals to access Medicare home health coverage and care. See https://www.gpo.gov/fdsys/pkg/FR-2017-07-28/pdf/2017-15825.pdf.

The Center for Medicare Advocacy has expressed ongoing concerns about the crisis in access to home health care, especially for individuals who have longer term conditions. http://www.medicareadvocacy.org/medicare-info/home-health-care/.

The proposed rules would further diminish access by paying home health agencies significantly less for individuals who have home health care needs longer than 30 days or who have not started home care within 14 days of being discharged from an institution, such as a hospital or nursing home. Payments to agencies would increase for individuals who were recently discharged home from an institution and who were expected to complete their need for home health care within 30 days. Accordingly, home health agencies would choose to serve individuals with short term needs and decline to serve individuals with long term needs.

The proposed rules, together with current payment and quality measure models, such as Home Health Value Based Purchasing and the Quality Reporting Program, would effectively deny millions of Medicare beneficiaries home the health care coverage and care they qualify for under Medicare law.

The Center responded to the proposed rules with an in-depth analysis of the devastating impact their adoption would have on vulnerable Medicare beneficiaries. The Center urged CMS not to adopt the proposed rules and, instead, to engage beneficiaries, advocates, and other stakeholders in meaningful discussions to develop a system that encourages home health agencies to offer care to all Medicare beneficiaries who qualify for coverage. 

Comments on the proposed rules were due on September 25, 2017. The Center’s response is available at http://www.medicareadvocacy.org/center-comments-on-proposed-home-health-payment-rules.


Continued Sabotage of the ACA

They’re at it again. As our attention was on the failed Graham-Cassidy bill to repeal the Affordable Care Act (ACA) and destroy Medicaid, the administration found yet another way to undermine ACA enrollment efforts. HHS officials announced that they will be shutting down healthcare.gov for significant periods of time almost every weekend during open enrollment. This is problematic for the many people who only have time on weekends to visit the site, research, and shop for a plan that meets their needs.

Having the time to choose the right health care plan is critical for individuals and families making these decisions. Unfortunately, the Administration has put up significant roadblocks such as cutting this year’s enrollment period in half, decimating the HHS outreach budget and slashing funding for community organizations that provide enrollment assistance to people who need health coverage. The Administration is also creating uncertainty by refusing – at least so far – to commit to paying cost sharing reductions for the full year. Many insurers have suggested that this intentional uncertainty is causing a spike in rates, sometimes in the double digits.

It is time for the Administration to stop undermining health care for millions of individuals who need and deserve quality coverage. It is time for them to stand up and work to protect our care. 


“Equitable Relief” Ends this Week!

Certain Medicare-eligible people who have health coverage through the individual Marketplace have until September 30th to enroll in Medicare Part B, or face late enrollment penalties.

People who don’t enroll in Part B when they are eligible often don’t realize that they will face late enrollment penalties for life. This can be a very expensive mistake. Equitable relief – enrollment without this penalty – has been offered to individuals enrolled in Medicare Part A and the Marketplace. It has also been offered to beneficiaries enrolled in Part A and the Marketplace but later enrolled in Part B with a penalty.  CMS has been offering equitable relief waivers and a Special Enrollment Period for these beneficiaries to sign up for Part B. Unfortunately, there has been no word from CMS if this relief will be extended past this week.  The Center signed onto a letter organized by our colleagues at the Medicare Rights Center requesting CMS to extend this time-limited equitable relief opportunity. 

With the deadline approaching very quickly, it is important that people apply for this relief by contacting their local Social Security Offices. Call Social Security at 1-800-772-1213 (TTY – 1-800-325-0778) or go to SSA.gov to find local offices. 

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