WASHINGTON (AP) — Medicare recipients COULD see a sizable new out-of-pocket charge for home health visits if Congress follows through on a recommendation issued Thursday by its own advisory panel.
Until now, home health visits from nurses and other providers have been free of charge to patients. But the Medicare Payment Advisory Commission says a copayment is needed to discourage overuse of a service whose cost to taxpayers is nearing $20 billion a year amid concerns that fraudsters are also taking advantage.
The panel did not prescribe an amount, but its staff has suggested the charge be $150 for a series of related visits. Medicare requires copays for many other services, so home health has been the exception, not the rule.
Defying opposition by AARP, the seniors’ lobby, the congressionally appointed commission voted 13-1 to recommend that lawmakers impose the new charge. Two commissioners abstained and one was absent.
Medicare pays for skilled home care visits currently, as long as a senior’s medical doctor approves of the skilled home care which only includes visits by one of the following skilled professionals: Registered Nurse (if there is an open wound or medical treatment that requires a R.N. to administer or monitor), Speech Therapists (S.T.), Occupational Therapist (O.T.), Physical Therapist (P.T.), and Certified Nursing Aide (C.N.A.).
These visits are approved for a short-time period to assist a senior in recovering from a medical condition such as a stroke or hip replacement. The senior must be showing improvement for the visits to continue to be approved.