Logistics for Lobbying Activities During NAHC’s Annual Meeting

NAHC Report recently urged its members to join their colleagues in Washington, DC October 31 – November 3 for NAHC’s Annual Meeting & Exposition - particularly for Thursday morning’s legislative activity and lobbying on Capitol Hill. Transportation will be provided to ensure that those participating in lobby day activities are able to attend educational sessions that begin at 11:30 AM and 1:30 PM, and the opening general session at 3:30 PM at the Gaylord National Resort.

It is important for home care and hospice advocates to, as Senator Susan Collins (R-ME) has said, "tell your Senators [and Representatives] about the compassionate care you provide and the budgetary problems you face.”

There is, indeed, no better way for home care and hospice advocates to make a difference and affect the outcome of legislation that will have an impact on their industry than meeting directly, with lawmakers, elected officials and their staffs. 

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. 

With home care and hospice advocates asking about how they can participate and do their part to fight to preserve access to home care and hospice, below are some details about getting to and from Capitol Hill from the Gaylord National Resort during this year’s Annual Meeting.

• Buses will run from the Gaylord National Resort to the Frederick Douglass Museum on Capitol Hill at 8:00am.
• A continental breakfast will be served at the Frederick Douglass Museum at 8:30am.
• Maps to the House and Senate offices will be available, as well as NAHC Staff who will be able to show attendees how to get to the appropriate office building.
• Lobby Day handouts – such as NAHC-authored white papers, one-page summaries of NAHC’s positions on key legislation, and other leave-behinds will be available at the Frederick Douglass Museum.
• Busses will leave from the Frederick Douglass Museum and return to the Gaylord Resort at 10:45 am, 12:45 PM, and 2:45 PM.

As a reminder, the first Educational Sessions of the day start at 11:30am. Buses are scheduled to get participants back to the Annual Meeting in time to attend the Educational Sessions for those who wish to do so

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 $175 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 a10 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.

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