Posted on Thursday, December 1, 2016 9:57 PM
Back in September, Republican Tom Price (R-GA) rolled out a bill to pause the Pre-Claim Review (PCR) demonstration. Now, President-elect Donald Trump has chosen 62-year-old Price to lead the Department of Health and Human Services (HHS).
The National Association for Home Care & Hospice (NAHC) worked closely with Price on the pre-claim bill.
“He has a deep understanding of the value of home care and hospice that we expect will be key to his actions with Medicare and Medicaid,” NAHC President Val J. Halamandaris stated.
Additionally, the Visiting Nurse Associations of America (VNAA) directed their attention on Price’s actions on pre-claim.
“VNAA is grateful to Republican Price for his strong advocacy on behalf of home-based care by co-authoring a letter to CMS opposing the implementation of a demonstration that requires prior authorization for certified agencies to bill for physician-referred Medicare home health services,” stated VNAA Vice President of Policy and Innovation Joy Cameron. “Following CMS’s August rollout of the Pre-Claim Review Demonstration program and its resulting problems in Illinois, Rep. Price introduced (along with Rep. McGovern) the Pre-Claims Undermine Seniors’ Health (Push) Act (H.R. 6226).”
Home health provides would definitely Praise Price if he eliminates PCR, however other issues might present itself. For example, bundled payments would be condensed under Price’s watch. Price has been adamant about making bundled payment programs large-scale and mandatory, while focusing heavily on the Comprehensive Care for Joint Replacement (CJR) program.
In late September, Price disapproved the CJR program in a letter to Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS). CMS overstepped its authority in rolling out these large-scale, mandatory programs through the Center for Medicare and Medicaid Innovation (CMMI), Price wrote. CMMI was created under the ACA to test new care and payment frameworks on a limited, voluntary basis, and pushing too far and too fast with these initiatives comes with great risks, he argued.
“These mandatory models overhaul major payment systems, commandeer clinical decision-making, and dramatically alter the delivery of care,” the letter states.
Looking past these home health-specific policies, Price is expected to implement Trump’s campaign pledge to repeal and replace the Affordable Care Act entirely.
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