The Centers for Medicare & Medicaid Services (CMS) finalized a permanent 7.85% cut to Medicare home health services in the 2023 Home Health Prospective Payment System (HH PPS) Final Rule. In the final rule, CMS acknowledged the significant cut would create “hardship” for providers, so the agency is phasing in half of the reduction — 3.925% — for Calendar Year (CY) 2023. The one-year phase-in, however, does nothing to mitigate the long-term impact of permanently cutting Medicare home health by 7.85%, or to address the significant flaws in CMS’ approach. While the cut in 2023 is halved, CMS states it will recoup the balance of the 7.85% cut in a future year along with other significant temporary payment reductions. Still, the 2023 cut alone is $635 million on an already shrinking benefit that serves 3.2 million Medicare beneficiaries annually.

• The 7.85% permanent cut equates to more than $1 billion in cuts annually starting in 2024 and continuing in perpetuity. This will result in devastating, long-term repercussions for home health patients and their providers.
• These cuts will total more than $18 billion over the next 10 years — even more than what CMS originally proposed in its proposed rule.
• CMS finalized calculations for additional “clawback cuts” of more than $2 billion for services provided to patients during the COVID-19 pandemic. On top of that $2 billion-plus cut, an additional estimated $1.5 billion will be clawed back from home health providers for services delivered in 2022 and 2023 cut (as a result of CMS phasing in the cut).
• More than half of Medicare-certified home health agencies will be operating under negative margins as a result of these cuts.
• CMS finalized these cuts despite strong opposition from patients, providers, and lawmakers.
• For two rulemaking cycles now, CMS has refused to alter its approach to calculating budget neutrality under the 2018 Bipartisan Budget Act, and instead, it has continued with a methodology that inflicts
  significant disruption and uncertainty into the vital home health benefit.
• CMS ignored data and recommendations from home health leaders warning about the agency’s methodology for justifying these cuts is deeply flawed and in violation of CMS’ statutory authority.

America’s home health community supports the Preserving Access to Home Health Act (S.4605/H.R.8581). This bipartisan, bicameral legislation prevents these massive cuts from taking effect in the Medicare home health program until 2026. The legislation provides time for CMS to work with the home health sector to re-evaluate and fix CMS’ flawed methodology in calculating Medicare rates.

We urge you to contact your members of Congress and encourage them to cosponsor this legislation!

Through the Medicare Payment Rule Advocacy Center, you can engage your lawmakers in the following ways:

• Send an email to lawmakers with just a few clicks
• Setup a meeting with lawmakers in their local offices
• Call your lawmakers' staff on Capitol Hill about your concerns
• Make your voice heard by attending a local event with your lawmakers
• Communicate with lawmakers on social media
• Write a letter to your local newspaper to raise public awareness

We need the entire home health community involved in fighting for the survival of home health agencies and the continued access to care for the millions of Americans who deserve and depend upon quality care in the home.

Below you will find talking points, fact sheets, and action steps. If you have any questions or need assistance with your advocacy efforts, please contact Kyle Simon, Director of Government Affairs and Communications, at ksimon@homecarefla.org or call (850) 222-8967.