The Partnership for Quality Home Healthcare today commended Representative Tom Price (R-GA) and his call for targeted Medicare reforms that achieve savings by putting an end to the occurrence of waste, fraud and abuse in the Medicare program. In a letter sent to his colleagues in Congress on May 22, Congressman Price asked fellow lawmakers to consider targeted program integrity reforms that protect patients instead of re-imposing copayment policies that impact innocent seniors and their access to Home Health Services.
In the letter, Congressman Price asks his colleagues to crack down on Medicare’s current ‘pay and chase’ anti-fraud approach and states, “By fighting fraud first, we can strengthen Medicare program integrity, safeguard our senior citizens and provider constituents, and deliver real savings to American taxpayers.”
Pointing to a recent article written by former Congressional Budget Office director Douglas Holtz-Eakin and healthcare economist Robert Book, which describes the unintended consequences associated with the re-imposition of the home health copayment proposed in the President’s Fiscal Year 2014 budget, Congressman Price reminds his colleagues that Congress repealed a similar requirement in 1972. Congress chose to eliminate the copayment because it created “a financial burden to many elderly persons living on marginal incomes” and drove patients to more expensive care settings.
According to a recent data analysis, home health beneficiaries are older, sicker and poorer than the Medicare population as a whole. As a result, reversing Congress’ 1972 repeal and requiring these seniors to pay out-of-pocket for home health could again compel low-income beneficiaries to obtain care in a more costly institutional settings or forgo needed treatment until hospitalization is necessary. Avalere Health estimates this could cause an increase in Medicare spending in other settings by as much as $16.7 billion.
Instead of re-imposing a copayment that unfairly burdens seniors, Congressman Price notes that Medicare should first go after the billions of dollars lost to waste, fraud and abuse each year by advancing targeted program integrity reforms.
History has shown that targeted program integrity reforms are effective in saving taxpayer dollars while protecting innocent beneficiaries and compliant providers. As Congressman Price details in his letter, a payment safeguard on outlier claims that the home health community proposed in 2009 has been in place since January 1, 2010 and is on track to generate $11 billion in savings over 10 years.
“We applaud Congressman Price for his leadership on program integrity reform,” stated Eric Berger, CEO of the Partnership. “Thanks to his and other concerned lawmakers’ efforts, Congress is considering positive reforms that can generate billions in savings without harming beneficiaries.”
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