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[quote=Anonymous]Hi OP, I unfortunately DO know all about this mythical 28 hours per week of home health aide that Medicare will pay for, under certain conditions.

Medicare will only pay for some home health aide care, if your patient requires skilled nursing care, O/T or P/T. It sounds like possibly a case could be made for that for your father.

However, even if Medicare agrees to pay for it, you would need to find a home health care agency who participates with Medicare who is willing to provide the staffing for this, and that's where the problem lies. They just won't do it.  The most I have heard of people getting (people with ALS) is a few hours a week of home health care. And the process to recertify every 6-8 weeks is time consuming as well.

From what I can figure out, the reason Home Health Care agencies won't staff the home health aides for more hours has to do with how Medicare pays them.  If your dad's doctor prescribed him in home skilled nursing, O/T, or P/T due to his medical condition, then Medicare pays the home health agency a certain amount of money for that 6 or 8 week period, depending on how debilitated your dad's condition is.  They get more money the more he needs basically - but it's still just in the $2000-$3000 range, mostly.

They then provide the services, so obviously there's a huge incentive NOT to provide all 28 hours of home health care. It comes out of their profit.

We need a new system where the home health companies get paid if they provide the services but apparently that led to a lot of fraud.

If you want to do a deep dive into the ins and outs of this, look into the Center for Medicare Advocady's recent Jimmo Symposium:

https://medicareadvocacy.org/center-symposium-on-the-jimmo-settlement/#:~:text=This%20virtual%20meeting%20brought%20together,we%20can%20do%20about%20it.

[/quote]

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