79 Organizations Call on CMS and ACL to Ensure Access to Medicare-Covered Home Health Care

Today, the Center for Medicare Advocacy sent a letter to the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) asking the agencies to ensure that the current Medicare law’s scope of home health coverage is actually available to those who qualify. The letter was signed on to by 79 national, state and local organizations. The letter is available at https://medicareadvocacy.org/wp-content/uploads/2021/06/Sign-on-Letter-Medicare-Home-Health.pdf.

As stated in the letter, the Medicare home health benefit provides coverage for a constellation of skilled and nonskilled services, all of which add to the health, safety, and quality of life of beneficiaries and their families. Under the law, Medicare coverage is available for people with acute and/or chronic conditions, and for services to improve, maintain, or slow decline of the individual’s condition. Further, coverage is available even if the services are expected to continue over a long period of time.

Unfortunately, however, people who legally qualify for Medicare coverage frequently have great difficulty obtaining and affording necessary home care, particularly home health aide visits (see, e.g., Center for Medicare Advocacy issue briefs: “Medicare Home Health Coverage: Reality Conflicts with the Law” (April 2021), available at: https://medicareadvocacy.org/issue-brief-medicare-home-health-coverage-reality-conflicts-with-the-law/, and “Medicare and Family Caregivers” (June 2020), available at: https://medicareadvocacy.org/wp-content/uploads/2020/06/Medicare-and-Family-Caregivers-June-2020.pdf).

In addition to urging CMS and ACL to work in partnership to ensure the current Medicare law's home health benefit is available to those who qualify, the 79 organizations ask the agencies to take advantage of an historic opportunity to expand home care coverage, including through President Biden’s pledged investment in home and community-based services (HCBS) by expanding access to Medicare-covered home health aide services.