LeadingAge Recommends Medicare Red Tape Relief

Legislation | August 29, 2017 | by Barbara Gay

In response to an invitation from the U.S. House Ways and Means Health Subcommittee, LeadingAge has submitted 15 separate recommendations for changes in laws and regulations governing nursing homes, home health care and hospice providers and the application of technology in the post-acute care field.

In July, 2017, Rep. Pat Tiberi (R-Ohio), chair of the U.S. House Ways and Means Subcommittee on Health, announced the “Provider Statutory & Regulatory Relief Initiative, . . . to identify areas where we can eliminate red tape and burdensome mandates that are driving up costs in the Medicare program.”  Rep. Tiberi invited stakeholder to submit recommendations on statutes or regulations that should be changed in order to eliminate burdensome mandates on health care providers.

In response, LeadingAge submitted 14 separate recommendations for changes in laws and regulations governing nursing homes, home health care and hospice providers and the application of technology in the post-acute care field. We incorporated feedback from many of our members and several of our state associations also submitted their own recommendations.

Rep. Tiberi’s subcommittee has primary legislative authority over the Medicare program. Now that the deadline for submitting ideas has passed, the subcommittee’s next step will be to hold roundtables with stakeholders across the country to “continue the conversation and identify solutions.” Rep. Tiberi envisions corrective legislation growing out of this process.

Thanks to all LeadingAge members and state associations who contributed suggestions, either to us or directly to the Health Subcommittee. We will continue working with Rep. Tiberi on much-needed regulatory reform for our field.

For nursing homes, we recommended:

  • Requirements of participation: delaying Phases II and III and reconsidering several, including the facility assessment;
  • Quality measures: simplify, integrate and risk adjust the various quality measures to which nursing homes are subject under Nursing Home Compare, the IMPACT Act, value-based purchasing and other initiatives;
  • 5 Star: develop national criteria, without a bell curve, applicable to all nursing homes. Lift the current 18 month freeze on 5 star ratings;
  • Survey and certification: allow joint training of nursing home and survey agency staff and permit state agencies to focus enforcement on poor performing nursing homes;
  • Observation stays/3-day stay requirement: count all time a beneficiary spends in the hospital toward the 3-day stay requirement. Establish a demonstration program to test the elimination of the requirement;
  • Fire safety: permanently waive the requirement for fireproofed structural steel members for nursing homes that are fully sprinklered;
  • Prompt pain medication for residents: permit nurses to act as physician agents and recognize chart orders as authorization for scheduled medications;
  • Use of patient lifts by teenaged CNAs: allow 16 and 17 year old certified nursing assistants with appropriate training to operate patient lifts.

For home health and hospice providers, we recommended:

To facilitate application of technology in the post-acute care field, we called for:

  • Financial support for post-acute and long-term services and supports providers to adopt and use interoperable electronic health records;
  • Give rural home health agencies access to affordable internet access through the Universal Service Fund’s Rural Health Care Program;
  • Explore the expansion of Medicare coverage of telehealth services to make them more available in long-term and post-acute care sector.