WASHINGTON, DC – U.S. Senator Pat Roberts, Co-Chairman of the Senate Rural Health Caucus, today addressed the National Association for Home Care and Hospice regarding cuts to Medicare reimbursements for home health care services.

The following are his prepared remarks:

"As the new co-chair of the Senate Rural Health Care Caucus, I understand even more how critical home and hospice care is for our seniors. In my home state of Kansas and other rural areas, many seniors live alone or out in the country miles away from a local hospital or doctor’s office.

"However, home care allows that senior the freedom and independence to stay in the home, and the comfort of knowing someone is there assisting with their health care needs. More importantly, home care is cost effective care that keeps a senior out of a nursing home or hospital.

"And, I know that a family must take great comfort in knowing that if they can’t be there, the local home health provider is there caring for their mother, father, grandmother, grandfather, sister, or brother. So, I want to truly thank you for you what you do. Your efforts have certainly not gone unnoticed.

"However, all of you here today know that your industry is on the chopping block by the administration. On the administrative front, last year CMS issued a plan to cut payments for home health services by nearly 12 percent over four years. The first of these cuts started on January 1 of this year.

"These cuts are based on CMS’s misguided and unfounded allegations of ‘upcoding’ or what they call ‘case mix creep’. Well, I think it was some creep at CMS that came up with this stupid idea. I am extremely disappointed that CMS implemented these cuts without any evidence or any input from Congress or those of you on the ground actually doing this work. More disturbing is that CMS has not made public any of the details on the research method, data and findings they used to justify the planned cuts! This certainly makes you scratch your head on what they’re up to over at CMS.

"I will spare you my usual CMS rant in the interest of time, but I have long had concerns that sometimes their outfit is more concerned with balancing the books rather than truly understanding the needs of Medicare beneficiaries and providers. This is why I refer to them as the ‘bean counters’. They’re focused on turning the red beans into black beans.

"This is why I have joined forces with Senator Susan Collins in cosponsoring the Home Health Care Access Protection Act to stop CMS from instituting these cuts, and instead establish a reliable and transparent process for understanding changes in case mix scoring. We have 18 cosponsors on this bill now and I will be urging more of my colleagues to join us in this effort.

"Unfortunately, on top of these administrative cuts, the president’s budget proposes to cut over $11 billion from Medicare home health spending by freezing provider payments over five years and instituting a permanent cut in the inflation update of 0.65 percent thereafter! Apparently they don’t think their regulatory cuts are enough.

"Well, I am here to tell you that I am doing everything I can to make sure this doesn’t happen. I am using my position on the Senate Finance Committee and Rural Health Caucus to tell my Senate colleagues to stop, listen and understand what is happening to your industry before moving forward with any cuts.

"I applaud your organization for being so well-armed with information showing the projected impact of the administrative cuts and the provider payment freezes in each state. It is certainly a dismal outlook not only in Kansas, but in every state throughout the country. I encourage you to continue to pound the pavement and show members of Congress in all of your states what your industry is up against!

"I have serious concerns that under the banner of ‘cost containment’ we are rationing health care. More concerning is that we are driving health providers out of the Medicare program. Sure, we can easily save some money by cutting provider payments or freezing annual payments, but we will be left with no providers willing or able to participate in the Medicare program - and what does that do for our seniors?

"On that note, I know all of you probably want to know what is going to happen with a possible Medicare package this year. As you know, in December Congress approved a short-term Medicare package to hold off the Medicare physician payment cuts until June 30 of this year. This means that the clock is ticking to get something done before June.

"It is my hope we’ll be able to come together and work in a bipartisan fashion to approve a Medicare package that makes some good improvements to the Medicare program, including reinstating the 5 percent add-on payment for home health services in rural areas.

"This is a provision I have long championed, and I included it in a comprehensive rural health care bill I introduced last June with Senator Kent Conrad honoring the late Senator Craig Thomas - the Rural Hospital and Provider Equity Act.

"I also want to assure you that I will not stand back and allow your industry to be used as a bank to pay for any Medicare changes. This is simply not fair and not sustainable for your industry, and I am committed to making sure this doesn’t happen.

"I want to thank all of you for allowing me to join you this morning. It was my godfather in this business, former Senator Frank Carlson, who taught me there are no self made men and women in politics. It’s your friends who make you who you are. Well, I have no better friends than those of you in this room. Thank you."

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