Home Care & Hospice Advocates Urged To Take Part In Lobby Day At NAHC Annual Meeting in Washington
Home Health, Hospice Community Should Participate on Thursday, October 31
September 13, 2013 08:50 AM
The home care and hospice community must continue to be involved and present a unified message as lawmakers continue their efforts to reduce the nation’s deficit and offset the cost of fixing the flawed Medicare physician payment formula - known as the “physician fix”. For previous coverage of the physician fix, see NAHC Report, January 3, 2013.
Home care and hospice representatives from across the country are meeting in Washington this year for the NAHC Annual Meeting, October 31-November 3, 2013. NAHC has scheduled a home care and hospice lobby day for Thursday, October 31, in conjunction with the NAHC Annual Meeting.
Participants in the NAHC Annual Meeting will fan out across Capitol Hill to advocate for home care and hospice. Transportation will be provided between the Gaylord Hotel where Annual Meeting participants will be staying and Capitol Hill. The message to lawmakers is “Oppose home care and hospice copays and payment cuts.”
The Annual Meeting and Lobby Day in Washington is well timed as Congress will be struggling to address funding the government for the next fiscal year, raise the debt ceiling to prevent a default on the national debt, and find alternatives to the draconian sequester cuts. In addition, lawmakers hope to prevent a 27 percent cut in Medicare physician payments and will be struggling to find offsets for the estimated $139 to $200 billion cost of the physician fix.
Copays and payment cuts have been proposed as a means of deficit reduction and offsetting the cost of the “physician fix”
The National Commission on Fiscal Responsibility and Reform (2010) (the “Bowles-Simpson plan”) recommended a uniform 20 percent copay for all Medicare services. This would amount to a $600 copay to access an episode of home health care. The chairs of the House Ways and Means and Energy and Commerce Committees, which have jurisdiction over Medicare, have recently expressed support for this proposal. The Congressional Budget Office put forth a 10 percent home health copay as one of its budget options for deficit reduction.
The Medicare Payment Advisory Commission (MedPAC) has recommended a home health copay (as much as $150 per episode) for episodes not preceded by a hospital or nursing home stay. The President’s budget included a proposed $100 home health copay for episodes not preceded by a hospital or nursing home stay, beginning in 2017 for newly eligible Medicare beneficiaries. The President’s budget also proposed a 1.1 percentage point cut in the inflation updates for all post acute providers, including home health. CMS has issued a proposed rebasing rule that, if not stopped or modified, will cut home health payments by 14 percent over four years.
Hospice patients and providers could also suffer significantly under some deficit reduction proposals. Medicare hospice spending per beneficiary averages approximately $11,500 annually; the uniform 20 percent copay proposal, if applied to hospice, could impose an average copay of about $2,300 annually per patient.
Additionally, existing regulatory and legislative payment reductions guarantee that, at best, hospices will experience flat payments for the foreseeable future. The Centers for Medicare & Medicaid Services (CMS) is working to reform the hospice payment system. Hospice providers need stability and predictability so that they can continue to make this vital service available to terminally ill Medicare patients.
Lobby Day participants may also raise other home health and hospice issues and seek support for legislation such as the Home Health Care Planning Improvement Act (S.1332/H.R.2504), which would allow nurse practitioners to sign home health plans of care; the Fostering Independence Through Technology (FITT) Act (S.596), which would provide incentives for the adoption of telehomecare; and the Hospice Evaluation and Legitimate Payment (HELP) Act (S.1053/H.R.2302), which would refine the hospice face to face requirement, require a demonstration of hospice payment reform, and increase hospice survey frequency.
If you have not already done so, please register for the NAHC Annual Meeting and join with your home care and hospice colleagues in lobbying Congress at this critical time.
You may obtain more information about the Annual Meeting and register here.