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Coverage of Certain Demonstration Projects under Medicare Modernization Act CMS Research Presentations at AcademyHealth 2004 The Medicare Replacement Drug Demonstration Medicaid Analytic eXtract (MAX) Data for Medicare Prescription Drug Plans View CMS Chart Series Need Data? ResDAC offers help in finding and using CMS data. |
Medicare Home Health Independence Demonstration
The Centers for Medicare & Medicaid Services (CMS) has implemented 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:
- a permanent, severe disability
- a permanent need for help with 3 of 5 Activities of Daily Living (ADLs)
- a permanent need for skilled nursing care
- a need daily attendant visits to monitor, treat or provide ADL assistance permanent skilled nursing care
- a need for technological or personal assistance to leave home
and who are not working outside the home. In addition, eligible beneficiaries must meet all current Medicare home health eligibility requirements other than those related to absences from 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 began in September and the demonstration was implemented on 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)
Information for Home Health Providers
Information for Referring Providers and Advocates
Information for Medicare Beneficiaries
Dialog meetings
Frequently Asked Questions
( October 2004; .pdf 121KB)Contacts:
Armen Thoumaian, Ph.D.
Phone: (410) 786-6672
Claudia Lamm
Phone: (410) 786-3421
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