Cochran, Wicker Challenge Data Used to Justify 14 Percent Cut

WASHINGTON, D.C. – U.S. Senators Thad Cochran (R-Miss.) and Roger Wicker (R-Miss.) have raised concerns that the use of incomplete information may result in a 14 percent cut to home health services for seniors over the next four years.

Cochran and Wicker are among a bipartisan majority of Senators who recently asked the Centers for Medicare and Medicaid Services (CMS) to use more accurate cost calculations to redraft a proposed rule regarding Medicare home health reimbursements. Fifty-one Senators signed a letter to CMS Administrator Marilyn Tavenner that outlines their concerns about the draft regulation.

CMS has proposed a draft rule regarding the 2014 Home Health Prospective Payment System (HHPPS) that would cut Medicare home health funding by 14 percent over four years, or a 3.5 percent annually between 2014 to 2017. The Senators assert that the home health payment rebasing calculations could limit access to home health services, especially in rural and underserved areas.

“The number of Mississippians who benefit from home health services continues to grow. The Centers for Medicare and Medicaid Services should not rush into implementing a flawed rule that could jeopardize the care for these vulnerable senior citizens,” Cochran said.

“Home health services are essential to patients in rural states like Mississippi,” Wicker said. “Arbitrarily cutting these critical services could drive many patients, particularly seniors, out of their homes and into more costly medical settings.”

The Senators ask CMS to consider using more current sources of data and analysis to more accurately reflect home health agencies’ costs per episode of care, rather than relying on 2011-era cost reporting data. The Senators are concerned that the draft rule fails to fully account for home health agencies’ costs associated with telehealth technologies, Health Information Technology, regulatory compliance, as well as hospital-based agencies’ overhead expenses.

“We are committed to ensuring fair and accurate payment for Medicare services, as well as access to care for people in their homes. That is why we urge you to consider additional data to more accurately reflect the full cost of care borne by home health agencies in determining rebasing,” the Senators wrote Tavenner.

“If finalized in its current form, the HHPPS proposed rule would raise serious concern about access to care for vulnerable seniors, especially in rural and underserved areas,” the Senators wrote. “We firmly believe in ensuring the accuracy of all Medicare reimbursement. However, we are concerned that the proposed rule may fall short of this goal due to its reliance on incomplete data and analysis that results in the under-counting of home health agencies’ costs per episode of care, and an inappropriately high rebasing adjustment.”

Senators Cochran and Wicker Press Release