Bipartisan Budget Act Passed February 9, 2018 The Bipartisan Budget Act of 2018 was passed on February 9, 2018. Even though it does not represent our total requests, this is a VICTORY for your efforts to contact your representatives in Washington! Here is a summary: •Five-year extension with reforms of the home health rural add-on until October 1, 2022. This year (2018) will reinstate the 3 % add on for rural areas. The reforms include a new methodology to target the add-on payment to those areas with a population density of six or fewer individuals per square mile. So for 2019 and following this will be adjusted downward depending on where the patient lives and the overall population. However it does require some testing by CMS. •Repeals the IPAB that is charged with making recommendations that reduce Medicare spending when per-capita growth exceeds an expenditure growth target. Repealing the IPAB has been a priority since its inclusion in the Affordable Care Act. While this advisory board was never officially established, or made actions, it posed a threat to payment rates and other potential cuts. If done so, Congress and the Administration would have had limited ability to avert their work. Eliminating its existence will protect providers from unfair and unjustified cuts. Hospice patients and providers will benefit from physician assistants (PA) becoming eligible to serve as attending physicians under the Medicare hospice benefit. Patients seeing a physician assistant as their primary care provider will now have the opportunity to enter into hospice care with that PA if they so choose. It also requires the HHS Secretary to reform the current home health payment system and implement a 30-day episode for payment, beginning January 1, 2020. This change is required to be budget neutral. There’s still likely work to be done on the face-to-face/physician certification issue, but progress has been made. Congress has acknowledged the burden and the need to address it. PLEASE REMEMBER THE WORK YOU DO IS IMPORTANT! WHEN YOU FIGHT FOR THOSE WHO CANNOT FIGHT FOR THEMSELVES IT MAKES A DIFFERENCE! THANK YOU!