Home Health & Hospice Week

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Hurricane Katrina may take its toll on home care providers for a long time to come, depending on how lawmakers approach the budget for disaster relief.

The hurricane has blown some legislation in the U.S. Congress off course. Katrina-related activities have bumped imminent legislation addressing health care information technology and physician reimbursement, congressional observers say.

Congress will also rethink its mission to cut $10 billion from mandated programs such as Medicaid and Medicare, lawmakers indicate.

Observers expect no reconciliation bill this year, which may mean no Medicare or Medicaid cuts that are usually included in such bills, notes Kathy Thompson with the Visiting Nurse Associations of America.

Beware: But home care providers shouldn't get too comfortable. Lawmakers are searching far and wide for funding required for Katrina relief, and mandated programs like Medicare are juicy targets. Home health agencies could face the usual proposals for a copayment for home health services and reductions to the market basket index inflation update, warns William Dombi with the National Association for Home Care & Hospice. "Those are the dollar trigger points for home care," Dombi tells Eli.

HHAs will fight such attempts in part by showing the increased cost of transportation for home care workers, considering record-high gas prices, Dombi says. And the transport problem is especially hard on rural agencies that have lost their rural add-on, he adds. Medicaid Coverage Assured Federal officials are working out agreements to pave the way for providers to get paid for treating the waves of Katrina evacuees. Under a newly agreed-upon waiver, Texas will provide temporary eligibility for five months of Medicaid coverage to a variety of evacuees including individuals with disabilities, low-income Medicare recipients, and low-income individuals in need of long-term care, the Centers for Medicare & Medicaid Services says in a release.

The federal government will pick up the full cost of these evacuees, as opposed to the usual cost-sharing arrangement for Medicaid.

A bill proposed Sept. 14 in the Senate wants to take Medicaid coverage even further. The legislation proposed by Senate Finance Chair Charles Grassley (R-IA) and Ranking Member Max Baucus (D-MT) would extend Medicaid coverage to hurricane survivors for five months. And the bill would establish federal add-on payments for providers serving increased Medi-caid populations due to Katrina or for providers who lost their population base due to the hurricane.

In a question-and-answer on its Katrina Web site, CMS says it won't do anything different to address an increased demand for home care services in certain areas. "CMS does not limit the number of patients that can be cared for by a home health agency," it says.

Providers in Louisiana and Mississippi can expect survey changes due to the disaster. The Louisiana Department of [...]