MedPAC is recommending a co-pay of $150 per episode, though that is just a
working figure with no details addressed. MedPAC believes that beneficiaries
consume more services when cost sharing is limited or nonexistent. They express
concern that the PPS pays for care on a per episode basis that rewards
additional volume and doesnt limit the number of episodes a beneficiary can
have. They believe that homecare should have a copay similar to other Medicare
services to encourage appropriate utilization.
But, in the
fall of 2011, political leaders that serve on the Joint Special Committee on
Deficit Reduction announced that they were unable to come to an agreement for
cutting the countrys budget deficit. Because they could not come to an
agreement, they will fall back on an agreed plan, which was created in case
they could not agree, referred to as sequestration. Under sequestration,
automatic cuts of $1.2 trillion dollars will be made over the next 10 years.
According to the National Association for Home Care and Hospice (NAHC),
exempted from cuts include Medicaid, Social Security, and Medicare beneficiary
cuts. Provider cuts are not exempt, but have been limited to two percent per
year. This lack of deal could result, then, in no copay being established
because it would be considered a beneficiary cut.
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