Langevin Pushing for Restored Funding for Home Care Services

(Washington, D.C.)–Congressman Jim Langevin is calling upon his colleagues in Congress to resist the addition of a financially burdensome co-pay for home health care services to upcoming Medicare legislation and to restore a 10 percent add-on for such services in rural areas that expired on April 10 of this year.  Langevin’s request comes on the same day he announced his membership in the Congressional Home Health Working Group, a bipartisan group of lawmakers that work together to improve the quality of care for homebound patients.

“Home health care fills a significant gap in the way our nation provides health care to our citizens, keeping them in their homes rather than in costly hospitals or nursing homes," said Congressman Langevin.  "The Home Health Working Group will work towards making home care affordable and available for all Rhode Islanders.”

The Balanced Budget Act of 1997 sought to curtail rising home health spending by requiring the implementation of a prospective payment system (PPS) under which home health agencies would be paid fixed amounts per episode of care for individual beneficiary.  Since passage of the 1997 Act, the number of Medicare beneficiaries receiving Medicare-funded home health services nationwide has decreased by approximately one million, or 30 percent.  Rhode Island experienced a 38 percent drop, the highest of any state. 

 Furthermore, the implementation of the PPS resulted in a 15 percent cut in payments to home health agencies.  While this cut affects home health providers at different rates, it is particularly burdensome for smaller providers, like many in Rhode Island.  The lack of funding has forced over 3,400 home health agencies nationwide to close their doors or deny services to Medicare beneficiaries.  The need for care remains, but not the resources.
 
The Home Health Working Group is also advocating for provisions within the upcoming Medicare bill that ensures those receiving home care services will continue to receive care in their homes, rather than costly hospitals and nursing homes.  Current negotiations on a Medicare bill contemplate adding a co-payment for beneficiaries who rely on home healthcare.  Congress eliminated co-pays on the Medicare home health benefit in 1972 to encourage the use of less costly, non-institutional services. 

A home health co-payment, if approved, would target the oldest, poorest, and most medically fragile of all Medicare patients by requiring them to pay higher out-of-pocket costs for needed healthcare.  In most cases, by the time a patient reaches the home health care system, he/she has already paid hospital co-payments, physician co-payments, a durable medical equipment co-payment and significant prescription drug co-payments - or the full cost for their medications - on an income of approximately $15,000 a year.

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