Federal Update 2-24-20

PDGM

Home health and hospice agencies across the country are about 8 weeks into the implementation of the Patient-Driven Groupings Model (PDGM), the biggest change to home health payment in the 21st century. The financial impact on Vermont home health and hospice agencies is not yet known. In March and April, our federal partners at the National Association for Home Care and Hospice (NAHC) are sponsoring 12 intensive seminars at locations around the country in March to share lessons learned so far and help agencies succeed in the new environment. Registration details are available HERE.

Public Charge Rule

Our partners at NAHC report that on January 27, a sharply divided United States Supreme Court narrowly decided in favor of allowing the controversial Department of Homeland Security rule, better known as the “Public Charge” rule, to go into effect while lower courts consider legal challenges. The rule is likely to make it more difficult for poor immigrants to receive green cards.
NAHC filed comments on the rule, focusing on the ramifications for home care and hospice workers, providers and patients. A reduction in the number of legal immigrants will only exacerbate a critical home care workforce shortage.

VA Claims Backlog and Rate Cut

The House of Representatives held a joint oversight hearing last week on significant implementation problems with the Department of Veterans Affairs (VA) new Community Care program. The VA and its partners accepted responsibility for problems which have delayed much-needed care for many veterans and delayed payment for home health agencies and other providers.

As background, following the passage of the VA Mission Act, Optum was named the third-party administrator for the VA Community Care Network for Regions 1 to 3, which includes Vermont. For months, Vermont agencies have been struggling to obtain payment for services from the former administrator, Tri-West, and from the VA. In addition, in December, Vermont agencies noticed a sudden, unannounced cut in reimbursement for in-home long-term care services for veterans. At this writing, we are hopeful this cut – which appears to have been a mistake – will be reversed.

NAHC president Bill Dombi’s provided testimony to the subcommittee.

The VNAs of Vermont extends its thanks to Vermont Senator Patrick Leahy and his staff who are actively helping members cut through red tape on these issues.