If there is one aspect of the dramatic cut in Veterans Administration home care rates that bothers providers in New Mexico and Texas, it is that it is not a uniform decrease.<\/p>\n
\u201cI don\u2019t understand why our state was targeted,\u201d a New Mexico VA provider of skilled and unskilled home care services told McKnight\u2019s Home Care Daily Pulse. \u201cWe have one of the [highest] poverty states already, and our veterans just didn\u2019t deserve it. If this was a national directive, that\u2019s fine. Then tell us there\u2019s a national directive to reduce the veterans\u2019 home care rates and reduce it across the board 3% 5%. But to come to a company and take away from the veterans 20% is just not feasible, and it doesn\u2019t make sense.\u201d<\/p>\n
Providers sounded the alarm<\/a> about the rate changes last December when the VA released the 2026 VA Schedule for Authorized Community Care. The adjustment, which went into effect Jan. 1 of this year, lowers reimbursement by as much as 43% for home health aide and homemaker services in rural areas in Texas and 19% for home health aide services in New Mexico. Texas has one of the largest populations of veterans in the country, the 2021 American Community Survey<\/a> found. New Mexico has roughly 145,000 to 150,000 total veterans. Of that population, approximately 66,000 to 68,000 are seniors over the age of 65, according to the US Census Bureau American Community Survey.<\/p>\n In a March 4 letter to Doug Collins, secretary of the VA, six senators and congressmen expressed \u201cserious concerns\u201d about the rate cuts in Texas and New Mexico and inquired about the methodology behind the cuts. In a May 1 response to the lawmakers\u2019 letter, Collins said the rate reduction in New Mexico and rural parts of Texas \u201creflect our assessment that prior rates for these areas significantly exceeded prevailing market rates. Aligning these rates with market conditions is not expected to affect veteran care.\u201d<\/p>\n In part because of the questionable reasoning behind the directive, the Polsinelli law firm now is representing a coalition of providers in New Mexico and Texas, including the aforementioned New Mexico provider.<\/p>\n \u201cThat\u2019s one of the potential reasons we\u2019re looking into challenging it: There does not seem to be rhyme or reason to it,\u201d Allessandra Stewart, an attorney with Polsinelli who specializes in healthcare reimbursement, told McKnight\u2019s Home Care Daily Pulse.<\/p>\n In an April 27 letter to Collins, Polsinelli attorney Angelo Spinola of Polsinelli argued that the rural reimbursement reductions set forth in the 2026 fee schedule are \u201cunsupported by substantial evidence, and are otherwise arbitrary and capricious within the meaning of the Administrative Procedure Act.\u201d<\/p>\n