National Association for Home Care & Hospice: 2017 Potential Home Care Legislative Priorities

The National Association for Home Care & Hospice (NAHC) is seeking member input on its legislative priorities for 2017. Please complete this questionnaire by Friday, February 3, 2017. Only one form per agency, please.

The potential priorities are organized by the following topics:
- Medicaid
- Medicare
- Other relevant issues

Question Title

* 1. How would you prioritize each of the MEDICAID issues below?

  Lowest Priority Highest Priority
Reverse or fund changes to the companionship services and live-in exemptions to the Fair Labor Standards Act.
Modify employer responsibilities in health care reform to address home care specific needs.
Ensure appropriate Medicaid rates for home care and hospice.
Provide sufficient Medicaid home care and hospice payments so that agencies can provide appropriate wages and benefits to caregiver staff.
Require Medicaid home care programs to offer a full range of delivery models and to meet quality of care standards.
Ensure access to home care in Medicaid managed long term services and supports.
Repeal Medicaid home health face-to-face encounter requirement.
Oppose per capita limits on federal Medicaid payments.
Establish minimum federal standards for home health coverage under Medicaid.
Establish federal standards for Medicaid personal care services.
Oppose reforms that turn Medicaid into a block grant program for the states.
Require Medicaid managed care organizations to contract with any willing and qualified provider.
Exempt home care and hospice from cost-sharing by Medicaid beneficiaries.
Develop and seek enactment of affirmative federal legislation to strengthen Medicaid home care as a required benefit instead of an optional one.
Require rebalancing of long term care services and supports expenditures in state Medicaid programs in favor of home care.
Support a consumer choice of provider in the provision of long term care services.
Provide access to Medicaid enrollment information.
Require Medicaid managed care organizations to obtain approval from the state Medicaid program and CMS prior to any reduction in provider payment rates.
Ensure demonstrations for dually eligible individuals maintain access to high quality home care.
Establish reasonable standards for consolidation of Medicare fee-for-service payments with Medicaid for dual-eligible beneficiaries.
Promote Medicare-Medicaid coordination.
Provide Medicaid payment for telehealth and remote patient monitoring.
Provide Medicaid incentives to adopt electronic health records
Eliminate the electronic visit verification mandate for Medicaid personal care services . or permit providers to utilize their choice of system.Eliminate the electronic visit verification mandate for Medicaid home health services . or permit providers to utilize their choice of system.
Maintain the expanded Medicaid eligibility in the Affordable Care Act.

Question Title

* 2. How would you prioritize each of the MEDICARE issues below?

  Lowest Priority Highest Priority
Oppose further Medicare home health rate rebasing and establish reasonable standards for any future rebasing Medicare home health services payment rates.
Repeal or reform Medicare home health face-to-face encounter requirement.
Abolish the Independent Medicare Payment Advisory Board.
Monitor the development and application of any new case mix adjuster in Medicare home health services.
Oppose any restructuring of Medicare cost sharing that could lead to barriers to home health services or hospice care.
Oppose any consolidation of Medicare fee-for-service payments with Medicaid for dual-eligible beneficiaries under the control of the state Medicaid programs that leads to limits on patient choice of provider or access to care.
Ensure a central role for home health agencies in new models of care, including care transitions programs, accountable care organizations, health homes, and chronic care management.
Ensure that proposals to bundle Medicare home health payments with other providers' payments offer full opportunity for home health agency participation and control of the bundled payment.
Ensure full market basket inflation updates to Medicare home health.
Block CMS regulatory "case mix creep" cuts and require a new process for calculating case mix adjustment.
Oppose copayments for Medicare home health services.
Provide a rural patient payment differential (add-on) to ensure access to care.
Require Medicare Advantage plans to obtain CMS approval of any value-based purchasing payment models for network providers.
Establish stability and equity among health care providers in application of the Medicare wage index.
Provide Medicare payment for telehealth and remote patient monitoring.
Provide financial assistance to home care agencies to support information sharing and the interoperable exchange of health information.
Allow NPs and PAs to sign home health plan of care and certify Medicare coverage eligibility..
Support targeted program integrity measures including strengthening Medicare participation standard for new home health agencies.
Oppose any mandate for use of Electronic Visit Verification in Medicare home health services.Create a Medicare home-based care management benefit.
Establish a home and community-based waiver-type program under Medicare.
Support value-based purchasing as a pilot project with reliable and valid performance measures and a reasonable payment incentive component with a 2% cap.
Oppose value-based purchasing reforms that do not predominatelyrely on patient outcome measures.
Ensure patient choice of providers and "truth in coverage" under Medicare managed care plans.
Ensure Medicare Advantage and fee-for-service enrollees receive identical home health benefits; prohibit Medicare Advantage home health cost sharing.
Maintain the Medicare beneficiary's freedom of choice of any qualified provider in any payment or care delivery innovations.
Protect providers against financial loss that unknowingly serve Medicare Advantage clients.
Eliminate payments in excess of traditional Medicare costs to Medicare Advantage plans.
Oppose untargeted application of Medicare surety bonds.
Oppose Medicare home health pre-claim review initiatives.
Require Medicare to increase payments rates consistent with any new regulatory requirements, including Conditions of Participation.
Oppose any limitation on the use of home health services to provide home infusion therapy under Medicare.
Oppose shifting Medicare to a premium support model that eliminates the current traditional Medicare program.

Question Title

* 3. How would you prioritize each of the OTHER issues below?

  Lowest Priority Highest Priority
Restrict passive enrollment of dual eligibles in Medicare Advantage plans.