House Letter to HHS, CMS Calls for Halt to HHGM

A bipartisan letter signed by 174 members of the U.S. House of Representatives has been sent to Eric Hargan, Acting Secretary of the Department of Health and Human Services (HHS), and Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), asking them to halt implementation of the proposed Home Health Groupings Model (HHGM) “until affected stakeholders can fully analyze and understand the impact of the proposed changes.”

After noting that home health “is a critical and cost-effective service for our constituents and the millions of seniors and people with disabilities who rely on it for treatment and high-quality care” in the home, the letter asks HHS and CMS to “refrain from finalizing the proposed HHGM” included in the CY2018 Home Health Prospective Payment System.

Pointing out that Congress has heard from stakeholders that the proposed rule lacks key methodology and important data points, the authors of the letter write that complete information “is essential for home health agencies to be able to accurately estimate the impact of the proposed HHGM on patient access and provider resources. It is essential that those most affected by the proposed rule have the opportunity, as well as the necessary information, to evaluate any consequences prior to the CMS finalizing the proposed reforms.”

CMS estimates the HHGM model and other changes in the proposed rule are not budget-neutral and could reduce Medicare reimbursements for home health services by as much as $950 million in 2019 alone. (NAHC estimates the proposed HHGM would reduce Medicare spending on home health by nearly $3 billion in 2019.) The letter authors support administration efforts to increase Medicare efficiencies, but note “this must be done in a prudent manner that does not compromise access to care for the increasing number of seniors and veterans who depend on these services to remain health and at home in their communities.”

The 174 Representatives who signed the letter “share CMS’ stated goal of more closely aligning home health reimbursements with the patients’ clinical needs.” Therefore, they ask CMS to not include the HHGM proposal in its final CY 2018 Home Health Prospective Payment System rulemaking “and instead work with relevant stakeholders, including home health agencies, providers and patient groups, in a more inclusive process” to develop and implement payment reforms.

NAHC worked closely with Congressional offices to build support for this letter and other advocacy efforts to halt implementation of the HHGM. Stay tuned to NAHC and NAHC Report for further developments in this critical issue.