NAHC to Congress: Sequester Relief and Telehealth Extension

The National Association for Home Care & Hospice (NAHC) has written a letter to Congressional leaders urging them to work to enact legislative proposals that will prevent billions of dollars in harmful sequestration-related Medicare rate cuts, as well as extend a key PHE-related hospice telehealth flexibility.

Online advocacy outreach campaigns have also been set up so that stakeholders can reach out directly to their congressional delegations and echo these requests to stop the looming cuts and ensure hospices can continue to perform the face-to-face recertification via telehealth after the public health emergency ends.

The letter, which was sent to Senate Majority Leader Chuck Schumer (D-NY), Senate Minority Leader Mitch McConnell (R-KY), Speaker of the House Nancy Pelosi (D-CA), and House Minority Leader Kevin McCarthy (R-CA), asks Congress to take steps soon to delay or avert scheduled cuts to Medicare that are set to take effect starting April 1, 2022. Absent congressional action, a three-month, one percent reduction in Medicare sequester payment reductions will be in place from April 1, 2022 – June 30, 2022, and the full two percent cuts will be in place from July 1, 2022 through the end of the year.

Joining NAHC on the letter are other major national associations representing hospices.

America’s front line health care providers continue to struggle through the COVID-19 pandemic, as well as a historically challenging workforce shortage, both of which have placed unprecedented stress on the entire health care system. Home health and hospice providers are working tirelessly to deliver the best care for patients, families and communities, despite battling major operational pressures. Ongoing financial challenges for home care providers include higher expenses for labor and supplies, lost revenues due to forgone routine visits, and increased emergency costs associated with new COVID-19 surges, among others. Allowing the scheduled Medicare cuts to take effect in April would reduce access to high-quality home-based medical and social services for those individuals and families who have never needed them more.

The letter also requests that Congress, as part of any broader legislative effort to expand COVID-related Medicare telehealth flexibilities beyond the end of the PHE, make sure to explicitly extend the waiver that is allowing hospices to perform the face-to-face (F2F) eligibility recertification via telehealth. Our hospice members have reported that being able to perform the F2F virtually has been a major success and should be permanently, or at least temporarily, expanded beyond the pandemic. Hospices are able to collect all necessary clinical information for recertification, follow patient and family wishes for fewer visits during the pandemic, and allocate staff more effectively due to this flexibility.

However, unlike many of the other pandemic telehealth flexibilities that are authorized in a blanket fashion under HHS’ expanded Section 1135 waiver authority, the hospice recertification flexibility is a separate, standalone statutory provision. Any future broad-based legislative extension of telehealth flexibilities implemented under the 1135 waiver authority would not address the hospice telehealth recertification allowance, so separate legislative action is required for this particular flexibility to be continued post-PHE.

Importantly, a number of popular bipartisan and bicameral bills do call for a permanent extension of the hospice F2F telehealth flexibility, including the Connect for Health Act of 2021 (S.1512/H.R. 2903), the Telehealth Modernization Act (S. 378/H.R. 1332), and the CURES 2.0 Act (H.R. 6000).

NAHC will continue to advocate for inclusion of important home-based care provisions in any forthcoming major legislative vehicles, including the omnibus government funding package currently being negotiated on Capitol Hill.