Home Health F2F Regulation and ACA Might Be Impacted by Trump’s Signed Executive Order

Posted on Friday, February 17, 2017 2:25 PM

On January 30, President Donald Trump signed an executive order that instructed departments and agencies to remove two regulations for every one issued. While this order affects all entities, the impact on the home health care industry may be the most profound.

According to attorney Robert Markette of Indianapolis-based Hall, Render, Killian, Health and Lyman, “If the government follows through on the order, it may simply end new regulations.”

Throughout the home health industry, many want the face-to-face regulation eliminated. However, Markette doubts that would happen.

While the annual rate rule is guaranteed to occur, there otherwise may be no new rules, adds Bill Dombi, Vice President for Law of the National Association for Home Care & Hospice. “As such, it is unpredictable what effect the 2-for-1 policy will have.”

Joy Cameron, Vice President of Policy and Innovation for the Visiting Nurse Associations of America, includes the following list of potential regulations/barriers to eliminate:
• Face-to-face
• Pre-claim review demonstration
• Limitation of advanced practice nurses (that is, nurse practitioner) from ordering and certifying home care under Medicare
• Immediate discharge when the patient is no longer homebound
• Homebound requirement
• Outlier caps
• Outlier payments linked to 15-minute increments

“Next to the tax code, the health care regulatory scheme is the most complex in the country,” notes Anders Gilberg, Senior Vice President of government affairs with the Medical Group Management Association, Washington, D.C.

There’s no shortage of areas that may see regulatory reduction, Gilberg says.

“The purpose of regulations is to set forth additional guidance to the public that is not included in statute,” says Daphne Saneholtz, attorney with Brennan, Manna and Diamond in Columbus, Ohio.

“Just because regulations add requirements and, potentially cost, does not mean they are unnecessary or not a good thing for an industry or the public,” Saneholtz counsels.

While the home health care industry awaits the consequences that are connected to the new policy, the signed executive order seems to achieve Trump’s promise to curtail bureaucratic hurdles. Also, it is also aligned with Rep. Tom Price, R-Ga. position to remove barriers between physicians and patients.

Not only does the executive order address the add-one-cut-two policy, it also calls for zero cost burden in fiscal year 2017.

“The heads of all agencies are directed that the total incremental cost of all new regulations, including repealed regulations, to be finalized this year shall be no greater than zero,” the order states.

For the full article, please see the February 13, 2017 Home Health Line Edition.

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