Non-Skilled In-Home Care is Now Allowed for Medicare Advantage

Ruby Posted by Ruby July 28, 2018

In April of 2018, CMS issued a final rule that non-skilled in-home care services will now be allowed as a supplemental benefit in MA plans starting in 2019.

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This is the first time that CMS has allowed supplemental benefits, such as services that improves quality of life, including coverage of non-skilled in-home supports and other assistive devices, and daily maintenance, in Medicare Advantage.

In February of 2018, when the rule was proposed, it witnessed great acceptance from the home health and private duty home care industries. The new rule is not just benefiting home care providers; it is now opening the doors for the growing MA population who are ready to pay for non-skilled in-home care services. Even before the official announcement of the rule, some providers have been positioning themselves to take on more personal care, with an eye toward MA trends.

According to CMS, “Under the new definition, the agency will allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”

“The final policies also advance the “Patients Over Paperwork” initiative – an effort aimed at removing regulatory obstacles and empowering patients to make informed healthcare decisions; developing innovative approaches to improving quality, accessibility, and affordability; and improving beneficiaries’ customer experience.”

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(News source: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-04-02.html)

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