HARTFORD — In an attempt to help elders stay in their homes while saving the state money, the House of Representatives on Monday overwhelmingly approved legislation that requires agencies employing home health aides and home care professionals to provide better training on recognizing and responding to harassment, abuse and discrimination.

 

The wide-ranging legislation, given a top priority this year by majority Democrats who labeled it H.B. 5001, passed 143-3. If ratified in the Senate and signed into law by the governor, the new law would require all home health care attendants, home health aides, homemaker-companions, and hospice agencies to supply employees with identification badges that include names and photographs to be displayed during each client appointment.

The May 1 go-live date for the Medicare hospice certifying physician enrollment requirement is delayed until June 3.  The Centers for Medicare & Medicaid Services (CMS) recently notified NAHC and NHPCO of this decision and will be making a public announcement soon. This follows our continued engagement with CMS to ensure the seamless and appropriate implementation of this requirement.

 

The hospice physician enrollment requirement was originally set to begin on May 1, as finalized in the Fiscal Year (FY) 2024 Hospice Wage Index final rule final rule. Under this requirement, a physician must be Medicare enrolled or validly opted-out in order to certify a patient’s terminal illness under the Medicare hospice benefit.

 

In past years, Medicare-certified home health agencies and Medicaid personal care services providers have been big focus areas for government watchdogs.

 

While there’s still plenty of oversight, the spotlight on home health and personal care providers appears to have dimmed somewhat. Instead of focusing on home health and personal care, watchdogs are increasingly targeting hospices, nursing homes and other areas.

 

The active work plan for the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) reflects this idea.

 

Publicly available online, the active work plan reflects OIG audits, evaluations and inspections that are underway or planned. As of March 2024, there were 241 items listed on OIG’s active to-do list.

 

Of those 241 items, just five – or less than 3% of the total list – involve home health, personal care or related services, such as consumer-direct programs, according to a Home Health Care News review of the active work plan.

In July of 2023, the National Association for Home Care & Hospice (NAHC) filed litigation against the United States Department of Health and Human Services (HHS) in federal court in Washington, D.C., challenging the Centers for Medicare & Medicaid Services’ (CMS) implementation of the Home Health Patient-Driven Groupings Model (PDGM) “Budget Neutrality Adjustment.” CMS has applied payment rate reductions of 3.925% and 2.89% in 2023 and 2024 respectively, using the challenged budget neutrality adjustment. Future rate cuts are expected under that adjustment authority.

 

The NAHC lawsuit challenged the methodology CMS applied in calculating the PDGM’budget neutrality adjustments mandated by Congress. The primary claim in our lawsuit is that the methodology violated the plain language of the Medicare law. The lawsuit also argues that CMS instituted the rate reductions in a manner that considered the change in volume of therapy visits, a violation of the requirement that CMS eliminate use of therapy thresholds

On April 23, the Federal Trade Commission (FTC) voted 3-2 to finalize a new rule largely prohibiting employers from enforcing non-competes against workers.

 

While the regulatory timeline on the non-compete ban is fairly immediate, the rule will face intense legal pressure from a variety of groups, mainly of which will come from health care. Regardless of what the courts eventually decide, home-based care employers need to understand the significance and ripple effects of Tuesday’s vote.

 

Chip Kahn, president and CEO of the Federation of American Hospitals, captured the ban’s impact on health care in a statement released shortly after the FTC voted. His remarks focus on hospitals, but the sentiments could apply to the home health, home care and hospice markets as well.