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Key bills have been introduced in the new Congress, which are similar to those not acted on in the last Congress. 

 They are bipartisan measures, which should improve their chances of passage.

Home Health Care Planning Improvement Act of 2017

* Legislation cosponsored by Sens. Susan Collins (R-ME) and Ben Cardin (D-MD), the Home Health Care Planning Improvement Act of 2017 (S445), would allow physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order Medicare home health services. “It makes no sense that they can order it when the patient is in certain facilities and then lose the right to order it when the patient goes home,” said Collins when introducing the bill. “These are skilled professionals who know what the patients need, and we should not be burdening the system with unnecessary paperwork.

The Preserve Access to Medicare Rural Home Health Services Act of 2017

* Rural home health agencies generally experience costs as much as 12 to 15 percent higher than those located in urban and suburban communities. The Preserve Access to Medicare Rural Home Health Services Act of 2017 (S353) cosponsored by Sens. Collins and Maria Cantwell (D-WA) would extend for five years the three percent add-on payment for home health agencies serving patients in rural areas. If nothing is done, the current rural add-on will expire in January 2018. “Your zip code should not determine your access to the highest-quality, most appropriate health care,” said Cantwell. “This bipartisan legislation makes sure patients who use Medicare in Washington’s rural communities receive more convenient, cost-effective care in their own homes.”

The Medicare Patient Access to Hospice Act of 2017 

* The Medicare Patient Access to Hospice Act of 2017 (HR1284) would expand current policy to include physician assistants as attending physicians. Currently, only medical doctors, doctors of osteopathy, and nurse practitioners are allowed to serve as an attending physician for hospice. Cosponsors are Reps. Lynn Jenkins (R-KS) and Mike Thompson (D-CA). “In some rural areas, physician assistants are the only local healthcare practitioner, leading patients to depend on them to diagnose and treat illnesses, prescribe medications, and otherwise manage the full range of their care,” said Jenkins. “Yet, Medicare payment policy prevents PAs from caring for patients when they and their families are the most vulnerable at the end of life.” HR1284 “will fix this issue by including PAs as authorized hospice providers under Medicare allowing continuity of care at a time when they need it most.”

Independence at Home Act of 2017

* Independence at Home Act of 2017 (S464) would establish a permanent Independence at Home medical practice program under the Medicare program. Chief sponsors are Sens. Ed Markey (D-MA), John Cornyn (R-TX), Rob Portman (R-OH), and Michael Bennett (D-CO). According to CMS, currently there are 16 participating sites involved in the Independence at Home Demonstration. Created by the ACA, The Independence at Home Demonstration is testing a service delivery and payment incentive model that uses home-based primary care teams designed to improve health outcomes and reduce expenditures for Medicare beneficiaries with multiple chronic conditions. The demonstration began in 2012 and was originally authorized for three years. It was subsequently extended for two additional years through September 30, 2017 by the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015. In Performance Year Two CMS reported in January, Independence at Home practices saved $7,821,374 in aggregate, an average of $746 per beneficiary. Seven participating practices earned incentive payments in the amount of $5,093,105.

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March/April 2019 Remington Report
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