The Top Legal, Regulatory Issues Home-Based Care Providers Are Facing In 2023
Home Health Care News | By Joyce Famakinwa
There are a number of key issues that home-based care providers looking to navigate legal and regulatory hurdles need to keep their eye on – some old, and some new.
In some areas, it will be important for providers to increase their advocacy efforts, like when it comes to a potential ban on non-competes, Angelo Spinola, the chair of home care, home health and hospice at the law firm Polsinelli, told Home Health Care News.
“When the industry has pulled together, worked together, and spoken in a singular voice, that has been a very effective strategy,” he said.
A potential ban on non-competes is just one of the many issues providers need to prepare for. HHCN recently caught up with Spinola and Katy Barnett – director of home care and hospice operations and policy at LeadingAge – to get a complete overview nearly halfway into the year.
Increased government investigations into the home-based care industry
During the height of the COVID-19 pandemic, many home-based care providers relied on the financial lifeline of government relief programs.
Moving forward, home-based care providers should expect to receive more attention from government watchdogs, as those relief programs — such as the Paycheck Protection Program (PPP), the Economic Injury Disaster Loan (EIDL) and employee retention tax credit programs — receive more scrutiny, according to Spinola.
“There’s been a lot of investigation around qualifications to participate in those programs, the use of funds from those programs, and I think we can expect to see that trend continue,” he said.
An increase in investigations means that providers will need to be more proactive.
“Understand what the requirements are, and take proactive steps to be in compliance with those requirements before the government investigation,” Spinola said.
Specifically, it will be imperative for providers to perform self-audits and be able to trace how they’ve spent these funds.
Aside from providers’ use of the aforementioned program funds, there is also more investigation activity around anti-kickback issues and referral relationships.
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Here's How Lawmakers Can Slash Medicare Spending Without Cutting Benefits
Forbes | By Sally Pipes
Politicians don't agree on much these days, but one thing seems to bring even Democrats and Republicans together. And that's refusing to cut Medicare.
That position may be politically popular. But it's at odds with the long-term sustainability of the program. Medicare's hospital insurance trust fund is set to go bankrupt by 2028. The program costs taxpayers $747 billion each year—12% of total government spending.
Fortunately, there's a way for lawmakers to rein in Medicare spending without cutting benefits. By giving seniors vouchers to spend on privately managed Medicare plans, lawmakers can cut costs while increasing quality of care.
Such a model, which already works in one part of Medicare, will help keep seniors healthy while protecting Medicare for future generations.
About 35 million Americans were enrolled in "Traditional Medicare," a fee-for-service system that covers hospital insurance, Part A, and medical insurance, Part B. The federal government administers Traditional Medicare directly, paying out nearly every claim submitted—including about 8% of improper claims, which cost the government around $32 billion each year.
Shifting to a premium support model would rein in Medicare payments. The federal government would give each senior a voucher for a fixed amount of money that they could spend on privately administered insurance or Traditional Medicare.
In other words, insurers would have to compete for seniors' business. They'd have to assemble benefits packages that appeal to potential customers. Competition would drive down costs and improve quality. And that's good news for John Q. Taxpayer, who would ultimately be footing the bill.
According to the nonpartisan Congressional Budget Office, if lawmakers had shifted to a premium support model in 2022, Medicare spending could have fallen between $21 billion and $419 billion by 2026, depending on whether existing beneficiaries participated in the model.
Making the shift today would save beneficiaries $333 billion over a decade, and taxpayers $1.8 trillion over 10 years, according to former CBO director and current American Action Forum president Douglas Holtz-Eakin.
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Resources About Alzheimer’s and Dementia
Care for Veterans with Alzheimer’s or dementia is provided throughout a full range of Department of Veterans Affairs (VA) health care services.
Based on the Veterans’ needs, services may include Home Based Primary Care, Homemaker and Home Health Aide, Respite Care, Adult Day Health Care, outpatient clinic, inpatient hospital, Nursing Home, Palliative Care, or Hospice Care.
Caregiver Support is also an essential part of these services. If you’ve been diagnosed with dementia, Alzheimer’s disease, or are caring for someone who has, become familiar with the types, stages, symptoms, and treatments.
Over 50 video and print resources have recently been added to the sections on:
Topics include daily plans, communication, behavior changes, next steps, and more. The Veterans Health Library has helpful resources about Coping with a Dementia Diagnosis.
Need more help or information? Find a VA social worker in your area or visit www.va.gov/Geriatrics. |
Now Available - Home Health Care 101 Webinar Recording
Originally Recorded: Wednesday, May 24, 2023
This interactive session is designed to provide students and practicing therapists who may be contemplating home health care employment with a broad understanding of what this setting has to offer. A variety of topics will be covered including variation of home environments, reimbursement, regulation, quality/satisfaction reporting, clinical interventions, problem-solving, and case study. The session will also touch on common myths, employment opportunities, benefits, challenges, technological advances, student affiliation, and entry level practice. Participants can expect to become well informed of home health practice and gain a better understanding as to whether or not this setting may be of interest in their career.
Speaker:
 Chris Chimenti earned his Masters of Science in Physical Therapy degree from Slippery Rock University in 1997. He is currently employed as the Senior Director of Clinical Innovation at HCR Home Care, a Rochester-based certified home health care agency operating across Upstate New York State. He has over 23 years of experience in the home health setting and is an accomplished speaker at both regional and national conferences on the topics of home health practice and regulation, clinical research, student affiliation, care redesign, and joint replacement rehabilitation. Chris has conducted a number of studies throughout his career across a variety of special interest areas including falls prevention, Parkinson’s Disease management, evidence-based standardized measures, pain assessment, sepsis screening, total knee replacement rehabilitation, and home health response to the COVID-19 pandemic. Chris has served APTA Home Health in a variety of leadership roles including Research Committee Chair, Treasurer, and Vice President.
*Please note - this webinar does not have CEUs.
To view the recording, click here: https://vimeo.com/831647012/31c3b6d752?share=copy
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Debt Ceiling Deal: What’s in, What’s Out of the Agreement to Avert US Default
AP News | By Kevin Freking and Farnoush Amiri
WASHINGTON (AP) — President Joe Biden and House Speaker Kevin McCarthy have reached an agreement in principle on legislation to increase the nation’s borrowing authority and avoid a federal default.
Negotiators are now racing to complete the bill’s text. McCarthy, R-Calif., said the House will vote on the legislation on Wednesday, giving the Senate time to consider it before June 5, the date when Treasury Secretary Janet Yellen said the United States could default on its debt obligations if lawmakers did not act in time.
While many details about the deal are unknown, both sides will be able to point to some victories. But some conservatives expressed early concerns that the compromise does not cut future deficits enough, while Democrats have been worried about proposed changes to work requirements in programs such as food stamps.
A look at what’s in and out of the deal, based on what’s known so far:
TWO-YEAR DEBT INCREASE, SPENDING LIMITS
The agreement would keep non-defense spending roughly flat in the 2024 fiscal year and increase it by 1% the following year, as well as provide for a two-year debt-limit increase — past the next presidential election in 2024. That’s according to a source familiar with the deal who provided details on the condition of anonymity.
VETERANS CARE
The agreement would fully fund medical care for veterans at the levels included in Biden’s proposed 2024 budget blueprint, including a fund dedicated to veterans who have been exposed to toxic substances or environmental hazards. Biden sought $20.3 billion for the toxic exposure fund in his budget and Republican negotiators ensured Sunday that funding was left untouched.
WORK REQUIREMENTS
Republicans had proposed boosting work requirements for able-bodied adults without dependents in certain government assistance programs. They said it would bring more people into the workforce, who would then pay taxes and help shore up key entitlement programs, namely Social Security and Medicare.
The agreement would expand some work requirements for the Supplemental Nutrition Assistance Program, or SNAP, formerly known as food stamps. It would raise the age for existing work requirements from 49 to 54, similar to the Republican proposal, but those changes would expire in 2030. The White House said it would at the same time reduce the number of vulnerable people — including veterans and people who are homeless — of all ages who are subject to the requirements.
Many of those changes will sunset in 2030, allowing Congress to measure the effectiveness of these changes and make changes if need be.
UNSPENT COVID MONEY
The agreement would rescind about $30 billion in unspent coronavirus relief money that Congress approved through previous bills, with exceptions made for veterans’ medical care, housing assistance, the Indian Health Service, and some $5 billion for a program focused on rapidly developing the next generation of COVID-19 vaccines and treatments.
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