CMS’s decision to continue a 3% temporary cut to Medicare home health payments is deeply disappointing. The annual increase does not repair years of underfunding or remove the threat of billions more in cuts to come.
We applaud CMS’s leadership in fighting fraud, including its move to expand the Review Choice Demonstration to California. Fraud steals resources from patients, undermines legitimate providers, and distorts the data used to set their payments. Strong enforcement must go hand in hand with adequate payment for legitimate care.
Since 2020, cumulative Medicare home health payment updates have totaled just 5.8%, compared with 20% or more for hospitals and skilled nursing facilities. Agencies compete for the same clinicians, yet their payments have fallen far behind.
As New York’s largest home health agency serving patients with some of the most complex needs, VNS Health sees the consequences firsthand. Continued cuts mean fewer resources for vulnerable seniors and people with disabilities. When skilled care is unavailable after hospitalization, families must fill the gap, putting patients at greater risk.
CMS must remove the 3% temporary cut and reevaluate past behavioral adjustments that have imposed billions in cuts and threaten billions more. Program integrity measures should stop payments for fraudulent care while preserving timely access to legitimate services. Patients and honest providers should not pay the price for fraud and flawed payment calculations.
