Dear Administrator Tavenner:

In recent months,  I have heard  from hundreds of Kentuckians expressing their concerns about the impact of the 2014 Home  Health Prospective  Payment System proposed  rule on continued access to home health services.

In particular, they worry that implementation  of the home health payment rebasing outlined in the proposed rule will result in nearly two-thirds of Kentucky  home health providers operating with no or negative margins.

I am concerned about the impact this regulation will have on patients’ access to home health services, particularly in rural areas of my state.

Kentucky’s home health agencies provide an array of incredibly  important services to the Commonwealth’s seniors.  At a time when the American  population is aging rapidly, home healthcare is a key part of the   solution to caring for these baby-boomers,  particularly  in rural communities where reaching an institutional setting may be more costly and more disruptive than staying at home,   I want to make sure Kentucky’s seniors maintain  access to these vital  services.   That means both safeguarding the Medicare trust-fund  from inaccurate or improper  payments, but also making sure that providers are appropriately compensated  for the services they provide.

As you know, the proposed  rule would decrease Medicare home health funding by 3.5 percent each year beginning  in 2014 until 2017, which is a  14 percent total reduction.  CMS has announced  that these reductions are required  by the Patient Protection and Affordable Care Act, commonly called Obamacare.  I strenuously opposed Obamacare, and specifically voted on several occasions to strike these home health cuts from the law because of my concerns that they could jeopardize access to care.  From the letters I have recently  received from every corner of Kentucky, it is clear these fears were well-founded.

While I opposed this law and continue to seek its repeal, I note that CMS has begun implementation, which requires rebasing for home health services with its 2014 payment rates.  In determining its final rates, I would encourage CMS to take all necessary steps to ensure that its payments accurately reflect the cost of providing home health services to this vulnerable population while protecting the Medicare trust fund.


See the original letter here.

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