NAHC to Congress: Stop the PAYGO Sequester Cuts

Learn more about this issue and many others NAHC is engaged with by attending the NAHC Advocacy Town Hall. It’s free to all.  The National Association for Home Care & Hospice has written to congressional leaders to urge them to  prevent the Statutory Pay-As-You-Go Act of 2010 (Statutory PAYGO) sequester from taking effect at the…

President Signs Bill Staving off Medicare Cuts

  • NAHC Advocacy win preserves almost $2 billion in payments

President Joe R. Biden signed legislation into law to delay significant payment cuts to Medicare providers after the bill easily passed the House of Representatives and Senate earlier in the week.

This represents a major advocacy win for NAHC and our members. By staving off the devasting rate reductions that were slated to start on January 1, 2022, Congress and the President recognize that providers of all kinds, including home health agencies and hospices, continue to be historically challenged by the pandemic and unprecedented workforce shortages. This action ensures that Home Health and Hospice providers can continue serving patients and families at a time when high-quality home-based care has never been more necessary.

“NAHC commends the Congress for coming together to address these backward rate cuts. We also thank the President for his swift signature ensuring home-based care providers across the country can continue to serve their communities without a major payment reduction imminently looming over their heads” said National Association for Homecare & Hospice President Bill Dombi.”

Text of the House bill can be found HERE.

The most relevant Medicare payment provisions in the new law include:

  • A three-month delay of the entire planned 2% Medicare sequester payment reductions, to be in effect January 1, 2022 – March 31, 2022 (i.e. no sequester-related payment reductions in effect for first 3 months of 2022)
  • A three-month, 1% reduction in Medicare sequester payment reductions, in effect April 1, 2022 – June 30, 2022 (i.e. a 1% across-the-board sequester-related payment reduction for Q2 of 2022)
  • A one-year delay until 2023 of the entire planned so-called PAYGO sequestration cuts, which were set to go into effect as a result of the budget deficit impact of the last major COVID-19 legislative relief package passed in March 2021. PAYGO cuts were estimated to be around $36 billion for Medicare providers.

Based on 2019 levels of Medicare spending for home health and hospice ($18.1 billion for home health; $20.9 billion for hospice), NAHC roughly estimates that the total savings across the two programs associated with this legislation reaches ~$1.85 billion.

The sequester-related delays in this bill are paid for by bumping up the sequester payment reduction amounts in the year 2030, and the PAYGO cuts are delayed for only one year until 2023. While this particular bill is very welcome news, the annual stress and threat of continued Medicare cuts is an ongoing challenge to home-based providers’ stability and predictability. NAHC is committed to fighting against harmful payment reductions and advancing sensible long-term sequestration relief.

There are other Medicare-related payment policies in the bill as well, including the maintenance of a 3% pay bump for Part B providers through 2022 under the Medicare Physician Fee Schedule, the delay of payment reductions tied to the clinical laboratory fee schedule, and a one-year postponement of CMMI’s radiation oncology payment model demonstration.

President Signs Bill Staving off Medicare Cuts

NAHC Advocacy win preserves almost $2 billion in payments President Joe R. Biden signed legislation into law to delay significant payment cuts to Medicare providers after the bill easily passed the House of Representatives and Senate earlier in the week. This represents a major advocacy win for NAHC and our members. By staving off the…

Congress Expected to Pass Bill to Avert Major Medicare Cuts

The US House of Representatives passed legislation during the evening of Tuesday, December 7, that would delay significant payment cuts to Medicare providers. The Senate is expected to vote on and pass the bill in the next few days, where it would then be sent to the President’s desk to be signed into law. Assuming President Biden receives the bill, he will sign it into law.

This would represent a major advocacy win for NAHC and our members. By helping stave off the devasting rate reductions that were slated to start on January 1, 2022, Congress is recognizing that providers of all kinds, including home health agencies and hospices, continue to be historically challenged by the pandemic and unprecedented workforce shortages. Should the bill become law as expected, the delay in cuts will support the ability of NAHC members to continue serving patients and families at a time when high-quality home-based care has never been more necessary.

“NAHC commends the House for coming together to address these backward rate cuts. We now encourage our friends in the Senate to follow suit and swiftly pass this bill so home-based care providers across the country can continue to serve their communities without a major payment reduction imminently looming over their heads” said National Association for Homecare & Hospice President Bill Dombi.”

Text of the House bill can be found HERE.

The most relevant Medicare payment provisions in the House-passed bill include:

  • A three-month delay of the entire planned 2% Medicare sequester payment reductions, to be in effect January 1, 2022 – March 31, 2022 (i.e. no sequester-related payment reductions in effect for first 3 months of 2022)
  • A three-month, 1% reduction in Medicare sequester payment reductions, in effect April 1, 2022 – June 30, 2022 (i.e. a 1% across-the-board sequester-related payment reduction for Q2 of 2022)
  • A one-year delay until 2023 of the entire planned so-called PAYGO sequestration cuts, which were set to go into effect as a result of the budget deficit impact of the last major COVID-19 legislative relief package passed in March 2021. PAYGO cuts were estimated to be around $36 billion for Medicare providers.

Based on 2019 levels of Medicare spending for home health and hospice ($18.1 billion for home health; $20.9 billion for hospice), NAHC roughly estimates that the total savings across the two programs associated with this legislation reaches ~$1.85 billion.

The sequester-related delays in this bill are paid for by bumping up the sequester payment reduction amounts in the year 2030, and the PAYGO cuts are delayed for only one year until 2023. While this particular bill is very welcome news, the annual stress and threat of continued Medicare cuts is an ongoing challenge to home-based providers’ stability and predictability. NAHC is committed to fighting against harmful payment reductions and advancing sensible long-term sequestration relief.

There are other Medicare-related payment policies in the bill as well, including the maintenance of a 3 percent pay bump for Part B providers through 2022 under the Medicare Physician Fee Schedule, the delay of payment reductions tied to the clinical laboratory fee schedule, and a one-year postponement of Center for Medicare & Medicaid Innovation’s radiation oncology payment model demonstration.

Congress Expected to Pass Bill to Avert Major Medicare Cuts

The US House of Representatives passed legislation during the evening of Tuesday, December 7, that would delay significant payment cuts to Medicare providers. The Senate is expected to vote on and pass the bill in the next few days, where it would then be sent to the President’s desk to be signed into law. Assuming President…

NAHC to Congress: Stop Looming Medicare Spending Cuts

Tell Congress to prevent devastating Medicare cuts! The National Association for Home Care & Hospice (NAHC) has written to Congressional leaders urging them to work together to enact legislative proposals by year’s end that will prevent tens of billions of dollars in harmful Medicare rate cuts to health care providers. We need to add your…