1999 HOSPICE ASSOCIATION OF AMERICA LEGISLATIVE BLUEPRINT FOR ACTION

TABLE OF CONTENTS

I. PRESERVING ACCESS TO HOME CARE AND HOSPICE SERVICES

L10. ENACT A COMPREHENSIVE, HIGH-QUALITY HOME- AND COMMUNITY-BASED LONG-TERM CARE PROGRAM

L12. OPPOSE PROPOSALS TO ìBUNDLEî HOME HEALTH AND HOSPICE BENEFIT PAYMENTS WITH PAYMENTS TO OTHER PROVIDERS

L15. ENSURE YEAR 2000 PROTECTIONS FOR HHAs

L18. MAINTAIN PERIODIC INTERIM PAYMENT FOR HOME HEALTH AGENCIES AND HOSPICES

L22. MAINTAIN COVERAGE FOR INDIVIDUALS WITH ONGOING HOME CARE NEEDS

L23. MAINTAIN AGGREGATION OF HOME HEALTH COST LIMITS

L24. REINSTATE THE PRESUMPTIVE STATUS FOR HOME HEALTH WAIVER OF LIABILITY

L25. PROHIBIT USE OF SAMPLING AUDITS

L26. SUPPORT MEDICARE COVERAGE OF DRUG THERAPIES IN THE HOME

L27. PERMIT DIRECT PROVIDER APPEAL RIGHTS

L29. ESTABLISH PROCEDURES FOR PROVIDER APPEALS OF SURVEY AND CERTIFICATION DEFICIENCIES

L30. AMEND THE EMPLOYEE RETIREMENT INCOME SECURITY ACT TO REQUIRE DIRECT PROVIDER APPEAL RIGHTS

L32. OPPOSE USER FEES FOR SURVEY AND CERTIFICATION ACTIVITIES

L35. EXEMPT ENTITIES THAT PERFORM WAIVED TESTS FROM CLIA CERTIFICATION

L36. OPPOSE DECREASING HOSPICE REIMBURSEMENT FOR DUALLY ELIGIBLE PATIENTS RESIDING IN NURSING FACILITIES

L37. ENSURE THE PORTABILITY OF ADVANCE DIRECTIVES

L38. REQUIRE DEMONSTRATION PROJECTS TO STUDY SPECIAL SERVICES AND FINANCING OF END-OF-LIFE CARE

L39. ENSURE THE PROVISION OF MEDICARE COVERAGE OF PAIN MEDICATIONS

L40. ENSURE ACCESS TO MEDICATIONS NECESSARY FOR PAIN CONTROL

L41. ELIMINATE MEDICARE PROVISION REQUIRING HOSPICE SOCIAL WORKER TO PRACTICE UNDER THE DIRECTION OF A PHYSICIAN

L42. COORDINATE GOVERNMENT REVIEWS OF HOME HEALTH AGENCIES TO REDUCE PAPERWORK BURDEN

L43. STRENGTHEN THE HOME HEALTH AIDE TRAINING REQUIREMENTS CONTAINED IN OBRA-87 AND APPROPRIATELY REIMBURSE AGENCIES FOR TRAINING COSTS

L44. IMPLEMENT INFORMAL COST REPORT REIMBURSEMENT APPEALS

L45. PERMIT SUITS AND AUTHORIZE PUNITIVE DAMAGES AGAINST FISCAL INTERMEDIARIES FOR BAD FAITH MEDICARE DECISIONS

L46. AUTHORIZE PUNITIVE DAMAGES LAWSUITS FOR BAD FAITH INSURANCE DECISIONS

L47. ENSURE THE RIGHT OF HOME HEALTH AGENCIES AND HOSPICES TO SELECT THEIR FISCAL INTERMEDIARIES

L49. LIMIT RETROACTIVITY OF FISCAL INTERMEDIARY DETERMINATIONS

L50. PRESERVE INDEPENDENCE OF ADMINISTRATIVE LAW JUDGES

L51. ENACT A NATIONAL STANDARD FOR PROCESSING ALJ APPEALS

L52. IMPROVE ACCESS TO JUDICIAL REVIEW FOR MEDICARE CLAIMS

L53. ENSURE AND ENFORCE BENEFICIARY CHOICE IN ALL HEALTH CARE PROGRAMS

L54. PRESERVE THE PUBLIC NATURE OF THE MEDICARE PROGRAM

L55. ALLOW EXPEDITED JUDICIAL REVIEW OF MEDICARE REIMBURSEMENT DISPUTES

L56. PROTECT CONSUMERS FROM ERRONEOUS SERVICE AND COVERAGE DETERMINATIONS

L57. STRENGTHEN REQUIREMENTS FOR PUBLICATION OF POLICY CHANGES BY HCFA

L58. OPPOSE COST-SHARING BY MEDICAID BENEFICIARIES

L59. REQUIRE COVERAGE OF HOME CARE, HOSPICE, AND PERSONAL CARE SERVICES IN ANY MEDICAID REFORM

L62. PROHIBIT STATES FROM USING COSTLY INDIVIDUAL CLAIMS REVIEW IN THIRD-PARTY PAYOR RECOVERY EFFORTS

L63. EXTEND SPOUSAL IMPOVERISHMENT PROTECTIONS TO HOME CARE

L64. ALLOW HOME CARE AGENCIES TO SERVE AS CASE MANAGERS IN FEDERALLY FUNDED PROGRAMS

L65. REINSTATE ACCESS TO MEDICAID IN WELFARE REFORM

L66. MONITOR SECTION 1115 MEDICAID WAIVER INVOLVEMENT IN CHRONIC CARE

L67. ENSURE HOME CARE REPRESENTATION ON MEDPAC

II. QUALITY MANAGEMENT, CONSUMER AND CAREGIVER PROTECTIONS, AND FRAUD AND ABUSE ISSUES

L68. ENSURE ACCESS TO QUALITY SERVICES IN MANAGED CARE PLANS

L69. ENACT HOME CARE SPECIFIC ANTI-FRAUD MEASURES

L72. OPPOSE EFFORTS TO STRIP BANKRUPTCY PROTECTIONS FROM HEALTH PROVIDERS

L73. ESTABLISH SAFE HARBORS AND DE MINIMUS THRESHOLDS UNDER THE FALSE CLAIMS ACT

L74. OPPOSE IMPLEMENTATION OF FEES FOR MEDICARE OVERPAYMENTS AND AUDITS

L75. REQUIRE FEDERALLY FUNDED CRIMINAL BACKGROUND CHECKS AND ESTABLISH A NATIONAL REGISTRY SYSTEM

L76. PROHIBIT GAG RULES IN MANAGED CARE CONTRACTS

L77. REQUIRE CONTRACTORS OF CARE IN THE HOME TO ENSURE SUPERVISION AND SUPPORT OF PARAPROFESSIONALS

L78. ENHANCE CONSUMER PROTECTIONS FOR HOME CARE RECIPIENTS

L79. DEVELOP QUALITY OF CARE STANDARDS FOR CONSUMER-DIRECTED CARE

L80. PREVENT VIOLENCE AGAINST HOME CARE WORKERS

L81. COORDINATE HOME CARE AIDE AND NURSING HOME AIDE TRAINING REQUIREMENTS

L82. ESTABLISH FEDERAL MEDICAID STANDARDS FOR PERSONAL CARE SERVICES

L83. MODIFY PREEMPTION PROVISION OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT

L84. ELIMINATE ELDER ABUSE

L85. AUTHORIZE THE IRS TO ISSUE RULINGS REGARDING INDEPENDENT CONTRACTOR STATUS

L87. RESTORE PERSONAL ASSISTANCE SERVICES AS A MANDATORY MEDICAID SERVICE

L88. PROVIDE SUFFICIENT HOME CARE PAYMENTS SO THAT AGENCIES CAN PROVIDE APPROPRIATE WAGES AND BENEFITS TO PARAPROFESSIONALS

III. ENSURING AVAILABILITY OF HOME CARE AND HOSPICE SERVICES

L89. PROVIDE ACCESS TO MEDICARE HMO ENROLLMENT INFORMATION

L91. SUPPORT TAX INCENTIVES FOR FAMILY CAREGIVERS

L92. MAKE HOME CARE MORE ACCESSIBLE TO PERSONS IN RURAL AREAS

L96. INCLUDE IN-HOME RESPITE CARE IN THE MEDICARE HOSPICE BENEFIT

L99. PROTECT PATIENTS' FREEDOM TO CHOOSE

L100. ENACT INSURANCE MARKET REFORMS

L101. ENSURE COVERAGE OF ACUTE AND LONG-TERM HOME CARE AND HOSPICE

L102. PROVIDE ACCESS TO MEDICAID ENROLLMENT INFORMATION

L103. CREATE A COMPREHENSIVE HOME CARE BENEFIT IN THE MILITARY HEALTH SERVICES SYSTEM

L105. FINANCE A HUMANE SYSTEM OF CARE FOR PERSONS WITH AIDS

L106. MANDATE HOSPICE COVERAGE UNDER MEDICAID

L108. IMPROVE HOME CARE SERVICES FOR VETERANS

L109. PRESERVE RIGHTS OF HOME CARE PATIENTS IN FEDERALLY QUALIFIED HMOs

L110. REAUTHORIZE AND AMEND THE OLDER AMERICANS ACT

L111. ESTABLISH MEANINGFUL STANDARDS FOR PRIVATE LONG-TERM CARE INSURANCE

IV. RECRUITMENT AND RETENTION OF HOME CARE AND HOSPICE PERSONNEL

L112. ALLOW LPNs TO SUPERVISE HOME CARE AIDES

L113. INCREASE AVAILABILITY OF THERAPISTS AND OTHER HOME CARE AND HOSPICE PERSONNEL

L114. PROVIDE FINANCIAL ASSISTANCE TO HOME CARE AGENCIES TO IMPLEMENT ELECTRONIC CAPABILITIES

L115. REQUIRE MEDICAL RESIDENTS AND INTERNS TO HAVE HOME CARE AND HOSPICE EXPERIENCE AS PART OF THEIR GRADUATE MEDICAL EDUCATION

V. HOME MEDICAL EQUIPMENT ISSUES

L122. ENCOURAGE STATES TO ADOPT A LICENSURE LAW AND REGULATIONS FOR HOME MEDICAL EQUIPMENT PROVIDERS

VI. PEDIATRIC HOME CARE ISSUES

L125. ALLOW PAYMENT FOR HOME HEALTH SERVICES FOR CENTER-BASED CARE FOR TECHNOLOGY-DEPENDENT CHILDREN

L126. IMPROVE REIMBURSEMENT REQUIREMENTS FOR PEDIATRIC HOME CARE UNDER MEDICAID

L127. REQUIRE DEMONSTRATION PROJECTS TO STUDY SPECIAL SERVICES AND FINANCING OF END-OF-LIFE CARE FOR PEDIATRIC PATIENTS

L128. PROVIDE ACCESS TO HOME CARE SERVICES FOR PEDIATRIC PATIENTS WITH MORE INTENSIVE CARE NEEDS

L129. PRESERVE RIGHTS OF PEDIATRIC HOME CARE PATIENTS IN FEDERALLY-QUALIFIED HMOs

L130. ENACT A HOMEBOUND DEFINITION THAT ENSURES ACCESS AND ELIGIBILITY FOR NEEDED HOME CARE SERVICES FOR PEDIATRIC PATIENTS


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