On July 6, 2023, The National Association for Home Care and Hospice (“NAHC”) announced that it has filed a lawsuit against the Centers for Medicare and Medicaid Services (“CMS”) which challenges the manner that CMS has reduced home health payment rates based on the payment rate methodology being used.
Based on the Complaint, “The Secretary’s final rule threatens to undermine this integral feature of our healthcare system in violation of express statutory requirements and his obligation to engage in reasoned decision-making. Instead of complying with Congress’s directives, the Secretary has unlawfully slashed the payments provided for home health services. And he has done so by effectively applying the same methodology for calculating payments—connecting payments to the amount of therapy provided—that Congress expressly sought to eliminate.”
NAHC is arguing that changes to Medicare payment rates are to be made in a budget neutral manner. However, CMS is imposing rated cuts that have caused service limitations or access to care. According to William A. Dombi, President of NAHC, “We have done everything possible to get Medicare to understand the disastrous consequences of its actions. We have presented hard facts, deep legal analysis, and extensive data to Medicare that demonstrates the errors in it policies. As a last resort, we have filed this lawsuit to protect Medicare beneficiaries and home health agencies that care for them.”
A copy of the Complaint filed is available at NAHC-Sues-HHS-Over-HH-Cuts.pdf.
The action by NAHC requests:
- Vacating any agency action found to be arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law, and remand any matters herein to the Secretary for further proceedings in accord with any legal instructions the Court may deem proper and just.
- Requiring the Secretary to change his regulations to comply with the statutory requirements, including faithfully implementing the applicable provisions of the BBA.
- Entering an injunction that (1) directs the Secretary to withdraw or suspend his Final Rule until such time as it can be brought into compliance with the statute, and (2) directs the Secretary to withhold applying the new Home Health PPS until such time as the Secretary has made appropriate revisions to his Final Rule.
- Ordering such other and further relief as the Court deems just and proper, including the award of costs and disbursements of this action and reasonable attorneys’ fees.
PERIOD 5 PRF REPORTING UNDERWAY
Many providers received Provider Relief Funding (“PRF”) between January 1, 2022, and June 30, 2022. The reporting for the use of these funds began on July 1, 2023. Lost revenues and COVID-19 expenses through June 30, 2023, are included in the report. Agencies should ensure that all COVID-19 PHE expenses have been identified and properly recorded in anticipation of making the required reporting.
THE HEALTH GROUP WILL BE EXHIBITING AT THE 2023 NAHC FINANCIAL MANAGEMENT CONFERENCE
The Health Group, LLC will be exhibiting at the 2023 NAHC Financial Management Conference in New Orleans on July 16-19, 2023. Stop by and visit with us to discuss cost reporting, hospice CAP liabilities and management, Medicare enrollment issues, acquisition/merger potentials, financial reporting, other matters of financial management interest, or just to chat. We look forward to seeing you at Booth #205. Of course, do not hesitate to contact us if you want to schedule a specific time to visit with us. You can still register for the conference at 2023 NAHC Financial Management Conference or register on-site.