The Effect of the Cures Act on Home Health Care

Signed into law in December 2016, the 21st Century Cures Act (Cures Act) is designed to help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently. The law builds on the Food & Drug Administration’s (FDA) ongoing work to incorporate the perspectives of patients into the development of drugs, biological products, and devices in the agency’s decision-making process. 

The law also included language to encourage the growth of home health care. The parts specific to home health care are in place to encourage home infusion therapy, expand remote patient monitoring (RPM), and reduce Medicare and Medicaid fraud.

In October 2018, the Centers for Medicare and Medicaid Services (CMS) announced changes to the Home Health Prospective Payment System. One of these changes involves Medicare covering certain in-home treatments through a home infusion therapy benefit. These benefits were not to be paid to home healthcare providers until 2021, however, under the Bipartisan Budget Act of 2018, home healthcare providers will receive “temporary transitional payments” in 2019 to bridge the gap until permanent benefits kick in. The new CMS rule also sets standards for health and safety standards for home infusion therapy providers.

The new CMS rule affecting the home health care provisions of the 21st Century Cures Act will also apply to remote patient monitoring (RPM). The rule will allow home health care providers to report RPM on Medicare cost report forms. A growing population of patients with chronic conditions across the country requires—and in many cases, demands—constant, quality care. As a result, healthcare organizations have begun to look to wearables and other new wireless technology to remotely collect patients’ vital health data, helping patients and saving money. The new rule encourages investments in technology and innovation. These are expected to improve patient outcomes through effective care planning and data sharing. 

The Cures Act also establishes new requirements for electronic visit verification (EVV) for Medicaid-covered personal and home health services, such as attendant services, in-home respite services and private-duty nursing. Beginning in 2019, under the new EVV requirements, home health care providers must record several key data points designed to help CMS ensure services submitted for reimbursement actually took place. The objective is to improve accountability and transparency in home health care. CMS is also creating a centralized database of home care providers as specified by the Cures Act. This database is designed to prevent health care providers flagged for fraud from crossing state lines to practice in another area. It will also facilitate state and federal agencies in confirming caregiver identities and communicating about suspected fraud. 

The 21st Century Cures Act is poised to transform the way Americans experience healthcare at home. Some aspects of the new rules will present challenges, but home health care providers can expect a boost from better reimbursement policies for in-home services and decreased Medicare and Medicaid fraud.

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