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Medicare Home Health Independence Demonstration
The Centers for Medicare & Medicaid Services (CMS) is planning the implementation of the Medicare Home Health Independence Demonstration, which is mandated under Section 702 of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003 (Public Law 108-173). Abt Associates Inc., of Cambridge, Massachusetts is assisting CMS in the implementation.
Section 702 of the MMA states that the Secretary shall conduct a 2-year demonstration in 3 states (representing the Northeast, the Midwest, and the West) in which Medicare beneficiaries with chronic conditions of a specific nature are deemed to be homebound, without regard to purpose, frequency, or duration of absences from home, for the purpose of receiving home health services under the Medicare program. Enrollment under the demonstration is limited to no more than 15,000 beneficiaries. Beneficiaries eligible for this demonstration are those with permanent, severe disability, who need permanent help with 3 of 5 Activities of Daily Living (ADLs), permanent skilled nursing care, and daily attendant visits to monitor, treat or provide ADL assistance, and require technological or personal assistance to leave home, and who are not working outside the home.
The purpose of the demonstration is to study the efficacy and cost to Medicare of providing home health services to Medicare beneficiaries with severe chronic conditions who otherwise would not be deemed homebound under the Medicare program. Under the demonstration, Medicare beneficiaries who qualify for Medicare home health benefits and meet the demonstration criteria can leave their homes more frequently and for longer periods without risking the loss of those benefits.
On June 3, 2004, Secretary Tommy Thompson held a press conference to announce the states selected for the Homebound Demonstration. The states selected are Massachusetts, Missouri, and Colorado. Implementation of a campaign within these 3 states to inform Home Health Agencies (HHAs), other pertinent providers, interest groups and beneficiaries is scheduled to begin in September with implementation of the demonstration expected to begin October 4, 2004.
- Summary and legislative language of Section 702 of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003 - ( September 2004; .pdf 21 KB)
- Home Health Provider Letter and attachments - ( October 2004; .pdf 241KB)
- Referring Providers and Advocates Letter and attachments - ( September 2004; .pdf 78KB)
- Medicare Beneficiary Letter
and attachments - ( October 2004; .pdf 129 KB)
Dialog meetings
- Dialog Agenda for Home Health Agencies - ( September 2004; .pdf 24KB)
- Dialog Agenda for Referring Providers and Others - ( September 2004; .pdf 32KB)
Contacts:
Armen Thoumaian, Ph.D.
Phone: (410) 786-6672
Claudia Lamm
Phone: (410) 786-3421
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