CMS’ Independence at Home Demonstration: Deadlines, Requirements and Legal Risks

In-home primary care providers may have an opportunity to participate in Medicare cost savings realized in providing care to chronically ill beneficiaries in the home setting. Pursuant to Section 3024 of the Affordable Care Act (P.L. 111-148), the Centers for Medicare & Medicaid Services (CMS) will conduct the Independence at Home (IAH) Demonstration to test home-based primary care for Medicare fee-for-service beneficiaries having multiple chronic illnesses. The IAH Demonstration will run for three years, and participating primary care providers will have the opportunity to receive a percentage of program savings, as determined by their performances on various quality indicators. If the home-based primary care is successful in forestalling the need for care in institutional settings, the proposed savings to be shared with providers could be substantial. Additionally, IAH providers will continue to bill and be paid standard Medicare reimbursement. Providers interested in participating in the IAH Demonstration must apply by February 6, 2012.

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