Home health pushes for more thought on CMS pre-claim policy

The home health sector is asking the Centers for Medicare and Medicaid Services for a bit more time to consider how the pre-claim rules for home health might affect seniors.

The Partnership for Quality Home Health Care (PQHH), a coalition of senior home health providers, has asked Congress to extend the time before Medicare’s new demonstration projects on home health care begin, allowing more time to rethink how the projects would affect seniors.

The Pre-Claim Undermines Seniors’ Health (PUSH) Act of 2016 asks for a one-year extension before Medicare begins national demonstration projects on home healthcare. The primary concer,k the PQHH organization says, is “pre-claim review policies as they currently stand will not only result in care delays, but higher costs to Medicare and patients, as patients who would otherwise be served in their home may be referred to higher cost settings.”

Illinois has begun the demonstration project already, a project “which has resulted in care denials and delays, and significant confusion among providers attempting to navigate the program. Many Illinois home health providers have reported difficulties understanding the program requirements, highlighting the need for this important piece of legislation,” according to an organizational statement from the PQHH.

Pamela Tabar

Pamela Tabar was editor-in-chief of I Advance Senior Care from 2013-2018. She has worked as a writer and editor for healthcare business media since 1998, including as News Editor of Healthcare Informatics. She has a master’s degree in journalism from Kent State University and a master’s degree in English from the University of York, England.