The Partnership for Quality Home Healthcare — a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation’s seniors – recently urged Congress to pass the Pre-Claim Undermines Seniors’ Health (PUSH) Act of 2016 to provide more time for implementing a Medicare home health pre-claim review policy to ensure Medicare and home health agencies are prepared to manage the process and maintain continuity of care for home health beneficiaries.
The proposed bill delays the Medicare demonstration for pre-claim review of home health services for one year to allow Congress, the Centers for Medicare & Medicaid Services (CMS) and home health stakeholders to work collaboratively to strengthen the program through proper education and training. There is concern throughout the Medicare community that pre-claim review policies as they currently stand will not only result in care delays, but higher costs to Medicare and patients, as patients who would otherwise be served in their home may be referred to higher cost settings.
Currently, the pre-claim review demonstration is underway in Illinois, which has resulted in care denials and delays, and significant confusion among providers attempting to navigate the program. Many Illinois home health providers have reported difficulties understanding the program requirements, highlighting the need for this important piece of legislation.
The PUSH Act was originally introduced by Congressmen Tom Price, MD (R-GA) and Jim McGovern (D-MA). Bipartisan lawmakers in both Florida and Illinois have asked CMS to delay the program.
