Home health/day-care demo project announced

Up to 15,000 Medicare beneficiaries will be able to receive adult day-care services while receiving home health services as part of a demonstration project announced by the Centers for Medicare & Medicaid Services (CMS).

"This demonstration will permit Medicare to assess whether providing medical adult day-care services through the home care benefit will improve patient outcomes and provide respite for beneficiaries' caregivers," says Mark B. McClelland, MD, PhD, CMS administrator.

Medicare-certified home health agencies, or corporate entities that include one or more such agencies, are eligible to be selected as demonstration sites.

The demonstration is limited to no more than five sites and associated adult day-care facilities that provide services in states that license or certify medical adult day-care facilities.

Participating home health agencies will be paid 95% of the home health prospective payment rate for services provided to beneficiaries participating in the demonstration.

3-year project starts in 2006

Up to 15,000 beneficiaries at any one time will be eligible to enroll in the three-year demonstration, which is scheduled to begin in February 2006.

Currently, Medicare beneficiaries who attend medical adult day-care facilities pay out of pocket for those services, or they are reimbursed through a third-party payer other than Medicare.

Under this demonstration, Medicare beneficiaries will be eligible to receive medical adult day services as a substitute for a portion of home health services that would otherwise be provided in the beneficiaries' home.

Since these adult day-care services will be provided in coordination with the home health benefit, beneficiaries will not have any associated out-of-pocket costs for these additional services while enrolled in the demonstration.

The deadline for submitting an application to participate as a demonstration site is Sept. 20, 2005.

For more information about the demonstration and to access the application form, go to www.cms.hhs.gov. Under "topics" on the left navigational bar, choose "demonstrations." Under "Open Solicitations," click on "Demonstration Project for Medical Adult Day Care Services."