Stimulus Lifts 2% Medicare Rate Cut, But Nursing Homes Largely Left Out — While Other Settings See Relief

The Senate’s landmark $2 trillion coronavirus stimulus package contains a temporary 2% bump on Medicare fee-for-service reimbursements across the board, but aside from increased funding for the federal government’s infection-control crackdown, skilled nursing facilities were largely left out of the post-acute relief.

The bill, which the Senate passed by a vote of 96-0 on Wednesday night, suspends the 2% across-the-board Medicare sequestration cuts that have been in effect since 2013, providing a slight boost to operators in the space.

The sequestration pause will last from May 1 to December 31 of this year.

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The legislation also allocated $200 million to support the Centers for Medicare & Medicaid Services (CMS) in its efforts to shore up infection-control inspections at the nation’s nursing homes — a central pillar of the government’s COVID-19 containment and compliance strategy.

But outside of those factors — and a blanket $100 billion in new funding that could eventually filter down to many types of Medicare- and Medicaid-certified providers — the bill did not offer specific assistance for skilled nursing facilities, while multiple other post-acute settings saw direct aid.

Clifton Porter, senior vice president of government relations at the American Health Care Association (AHCA) — which represents for-profit nursing homes across the country — praised the Senate’s action as a critical first step, but noted that more assistance will be needed down the road.

“We appreciate the many items in the Senate stimulus bill that will be helpful for long-term care providers, including the loans for small businesses, the funds supporting increased health care resources and medical supplies, and the support for child care, which will greatly support our caregivers on the front lines,” Porter said in a statement provided to SNN. “We hope the House will pass this swiftly so that funds can be deployed as quickly as possible.”

Other acute and post-acute sectors received specific relief language in the massive stimulus package.

Hospitals, for instance, pulled down a 20% boost to the diagnosis-related group (DRG) rate COVID-19 patients upon discharge. Inpatient rehabilitation facilities (IRFs) and long-term acute care hospitals (LTACs) were granted waivers relating to payment rates and the mandatory provision of therapy.

The bill also specifically encourages the development of telehealth infrastructure in the home health industry, while also relaxing rules regarding certification of patients for home-health eligibility, as our sister site Home Health Care News reported.

Previously, only physicians could approve people to receive home health services; the bill allows a wide variety of providers, including physician assistants and nurse practitioners, to certify patients for care.

The home health industry in particular is hopeful that the emergency measure will make permanent those changes, which leaders have been working on implementing for some time.

“The Senate bill contains a number of pieces of relief for both home health agencies and hospices,” William Dombi, president of the National Association for Home Care & Hospice (NAHC), told members in an online update video released this week. “Our longstanding bill on nurse practitioners and physician assistants may actually become law.”

Hospice providers, meanwhile, won the ability to conduct telehealth interventions, as our sister site Hospice News reported.

“This is one of our key priorities for legislative action, and we are grateful to members of the Senate and House for including this change in the pending relief package,” NAHC vice president of hospice policy Theresa Foster told Hospice News.

Earlier in the week, Sen. Ben Sasse of Nebraska introduced an amendment to the legislation that would have included a 15% Medicare fee-for-service rate increase for COVID-19 residents at skilled nursing facilities, citing the higher cost of caring for those patients; that amendment did not make it into the final bill.

The Senate bill must now receive approval in the House of Representatives; a vote is expected Friday, with House Speaker Nancy Pelosi predicting a swift passage in comments to reporters Thursday.

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