This is a shocker with all the aging boomers.

The Center for Medicare and Medicaid Services (CMS) snuck into the realm “quietly” according to The Washington Examiner on November 22, 2013. CMS decided to call for a 3.5% cut per year, over the next four years–14% total by the end of four years–to Medicare Home Health Care services. That has got to hurt! Not only Medicare enrollees, but Home Health Care companies, too. The Daily Caller headlined it this way, “Obamacare’s Homecare Cuts to Sick and Old New Year’s Day.” Benefits Pro headlined, “Obamacare’s New Year’s Day Surprise “Deep Cuts to Medicare.”

Why and how? You already know the answer. This move is part of the infamous PPACA which allows CMS/DHHS to do as they see fit to achieve the $700+ billion cuts from Medicare to supply dollars for Obamacare–think subsidies here–no matter how they describe it.

As stated by Richard Pollock in The Washington Examiner, “An estimated 3.5 million poor and ill homebound senior citizens will wake up on New Year’s Day to discover Obamacare has slashed funding for their home health care program. The program cuts health care in the homes of seniors suffering from acute or chronic afflictions, or who are in need of rehabilitation therapy. By CMS’s own calculations, 40 percent of nearly 5,000 home health companies–mainly small businesses–will experience a ‘net loss’ in revenue due to the cuts and will go into the red by 2017. That will put many of them out of business. The National Association of Home Care and Hospice calculates the losses will be much more severe, affecting 75 percent of all home health care companies. Nearly a half million skilled home care workers are also projected to lose their jobs over the next four years due to the cuts, according to the program’s supporters.”

More tidbits: 1) The cuts may have a disproportionate impact on minorities and those living in under-served rural communities. 2) Two out of three home health care recipients fall at or below the federal poverty line. 3) One in four seniors getting home health care are age 85 or older. 4) Fifty-one Senators and 142 members of the House wrote letters to Marilyn Tavenner asking her not to impose the cuts. It didn’t matter.

Andrew Mangione wrote in Benefits Pro, “To my knowledge, this is the first time that any regulation has been issued by any administration with the knowledge that it would put nearly half of the people it impacted out of business. Indeed this Obamacare cut to Medicare is so severe that thousands of small businesses may be forced to close, and hundreds of thousands of quality jobs could be lost–directly impacting the millions of homebound seniors who depend on them.”

What’s the takeaway? First, CMS has complained for years that Home Health Care agencies are making too much money. In fact, it has had its hand to the throat of HHC agencies for several years, finding that some are submitting false claims. How does that make HHC any different than the rest of the medical care arena? Fraud has been repeatedly reported in the rest of healthcare, and HHC agencies don’t have a monopoly.

So why punish the industry? Simple. CMS did not have to make any cuts, or at the very least could have made moderate cuts, but that’s not the idea. The idea is to transfer money to Obamacare–short answer–sweet and simple.

Isn’t it difficult to understand why, in this day and age, when we are trying to keep people out of nursing homes, and keep them in their own homes, CMS chooses to exacerbate the problem with this numb-skulled approach to the problem of where to receive care? But read on.

Here’s the point. The HHC agencies (nurses/caregivers) will be forced to tell their clients that they cannot continue to serve them as they have, and that over the next four years, the problem will become more severe. Home health care recipients will tell their children, who are trying to keep mom, dad, grandpa and grandma out of the nursing home, what is happening. They will also tell their friends. And people will start asking their Senators and Representatives if they voted for Obamacare, and the ax will fall for those who did. This will not remain a silent matter even though it was stealthily administered. 

This is but another of countless regulations and “rewrites” of Obamacare rules, as the current president continues to change the rules and bend the rules to his own satisfaction, as the rest of America deals with the mess he and his congressional subordinates made when they shoved the matter into the faces of Americans, in order to “find out what’s in it.”

Here’s an incredibly cruel event regarding the hospital “admitted” verses “observational” controversy.

Think we had topped the chart for the foolishness of CMS rules regarding hospitals “admitting” patients as opposed to having to code them as being there under “observation” in a previous EHB monthly newsletter?

Well, now the Center for Medicare Advocacy, Inc. tops that with disclosure of an incredibly cruel example of Medicare’s iron hand [and confusing] rules for hospitals to cope. Here’s what they revealed:

Mr. Blake is an 85-year old grandfather who fell and was taken to the emergency room with a broken back and internal bleeding. After being treated for eight days, the hospital still denies him as an inpatient.

Instead, they claim Mr. Blake is simply an ‘outpatient under observation status.’

Because he is not considered an inpatient–despite a broken back, internal bleeding and spending over a week in the hospital–Mr. Blake and his family will be responsible for the entire cost of his rehabilitation and follow-up care at a skilled nursing facility. If the hospital acknowledged Mr. Blake as being cared for as an inpatient, Medicare would cover the cost of the necessary rehabilitation and follow-up care.

Now, attorneys at the Center for Medicare Advocacy are working to help Mr. Blake and his family.

So that’s what it takes? Attorneys have to get involved with CMS and hospitals to right something so obviously wrong? Sadly, 1.6 million people lost their right to Extended Care [skilled care in a skilled care facility] in 2012. And, the problem is growing. Why?

Well, nobody seems to be able to understand the CMS new “two midnight” rule regarding “admittance.” Most hospital stays lasting less than two midnights are to be considered outpatient stays under the rule. But what about those stays lasting more then two midnights; in fact as long as eight midnights?

This monster is getting bigger. Research conducted for Citigroup found that inpatient admission to hospitals declined 4.5% in November from their levels a year earlier. The study also found that the year-over-year growth in overall admissions was the weakest in 11 years.

So, where does that leave us? In a pretty precarious position, wouldn’t you say? Remember the fact that if Medicare pays nothing, then a Medicare supplement policy pays nothing. In short, there is nothing to supplement. Medicare Advantage companies each have different rules as to how to solve this problem, but the base problem continues and is getting worse, as evidenced by this news.

We hope you are able to really understand this dismal information, should you or a loved one be faced with and trapped in the “admitted” (which becomes a “non-admitted” category) and winds up being a Medicare Part B (outpatient) claim.