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Medicare home health care may soon carry charge

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medicare paymentIn contrast to current Medicare policy, the Medicare Payment Advisory Commission has issued a new recommendation that seniors be charged copayments for home health care visits. The recommendation is designed to reign in the cost of home health care, which currently runs $20 billion per year. To date, seniors have received this type of care free of charge.

The Medicare website stipulates that in order to qualify for home health care, beneficiaries must be referred to the program by their physicians, require skilled nursing care, be approved by the Medicare program and be homebound and unable to leave home without assistance.

While some members of the commission expressed concern over the recommendation’s impact on seniors of modest means, the vote was nevertheless 13 to 1 in favor of passing the recommendation along to lawmakers. Low-income seniors would be exempt from the requirement, as would recently discharged hospital patients.

The copayment is aimed at discouraging abuse and overuse of the system. “At the extreme, this benefit can turn into a long-term care social support system,” says the congressionally appointed commission’s chairman Glenn Hackbarth. “A modest copayment is one tool to help deal with that problem.”

Furthermore, there is concern that fraud has been creeping into the system, and the commission hopes a copayment would limit such activity. While the commission did not make any explicit recommendations regarding a copayment amount, the sum of $150 for a series of related visits has been proposed.

Presently Medicare requires copayments for many of its services, but until now home health care has been the exception rather than the rule.