NH CARES Issues for Home Health Services - 3/23/09
Granite
State Home Health Association
BEAS HB1 Page: Page 1437, Class 529 Home
Health Services
OMBP HB1 Page: Page 1640, Class 101, Medical
Payments to Providers
The Governor’s budget
freezes reimbursement rates for home health services for the FY 2010-11
biennium. We ask that that the DHHS
proposed maintenance budget levels be restored to HB 1 in order to retain some
level of access to home health services for Medicaid clients. Specifically, the following additions are
needed (total funds; GF amount varies depending on final FMAP numbers):
Add
$324,000 in FY10 and $689,000 in FY11 BEAS page 1437 Class 529
Add
$324,874 in FY10 and $252,004 in FY11 OMBP page 1640 Class 101.
Why is this increase needed?
A) Decreasing revenues have
already forced many agencies to limit the amount of Medicaid care they deliver,
resulting in reduced access to home health services for Medicaid clients in New
Hampshire. Without rate increases,
access to skilled nursing and home health aide services will decline sharply in
the coming biennium, as agencies work to trim losses so they can remain
available to deliver needed care to the broader community.
B) When skilled home health
services are not available, Medicaid patients will incur higher costs through
greater use of hospital, physician and nursing facility services.
C) According to the most
recently available Medicare cost reports for home health services in NH, the
current Medicaid reimbursement rate covers less than half the cost of a skilled
nursing visit, and only 37% of the cost of a short (less than 2 hrs) home
health aide visit.
D) Federal regulations
require home health agencies to be Medicare-certified in order to enroll as a
Medicaid provider (except for waiver program services); Medicare regulations
incur significant costs for providers.
E)
Medicare is the major payor source for almost all certified home
health agencies in NH, and has generated the positive margins in the past that
agencies have used to underwrite Medicaid losses. Reimbursement rates for Medicare home health services have
decreased in the past several years, and are proposed to decrease significantly
in the 2010 and 2011 budgets proposed by the Obama administration.
F)
We need the Legislature to do all it can to find the revenues to help
us meet these needs. Helping our most vulnerable citizens is one of state
government’s fundamental responsibilities.
Contact
Susan Young, Executive
Director, Granite State Home Health Association
225-5597 syoung@homecarenh.org