U.S. Representatives Chris Collins (R-NY-27), Janice Schakowsky (D-IL-9), Patrick Tiberi (R-OH-12) and Ron Kind (D-WI-3) have introduced the Home Health Care Planning Improvement Act of 2017 (H.R. 1825), in the U.S. House of Representatives. The bill was referred to the House Energy and Commerce Committee where it is supported by its Chairman Rep. Greg Walden (R-OR-2) who had sponsored the bill in the 114th Congress.
Currently Medicare law requires that a physician certify a patient’s eligibility for coverage of home health services. Since 1965 when this law was made many older adults now receive care from the mid-level practitioners, such as nurse practitioners and physicians assistants. With the law as it currently reads, a person needing home health services must see a physician (different from their regular provider, say an ARNP) to receive home health services. This is both inefficient and the physician doesn’t know the client.
Permitting nurse practitioners to certify Medicare eligibility enhances Medicare safeguards in the Home Health Benefit as the certification is done by the actual practitioner that is actually caring for the beneficiary. This in turn allows these mid-level practitioners to improve the transitions of care of patients to community-based care potentially resulting in a decrease in the length-of-stay at hospitals and skilled nursing facilities as it would no longer be necessary to insert a physician who has not cared for the patient into the process. Also this allows the nurse practitioner to continue providing the care and orders for the home health team instead of requiring an uninvolved physician into the mix.
Last year this legislation had 206 bipartisan support. This is cost savings and improves patient safety. (from National Association of Health and Hospice website).