NAHC Holds Teleconference to Share Latest Congressional Developments with the Home Care & Hospice Community
December 17, 2013 09:39 AM
The National Association for Home Care & Hospice (NAHC) held a teleconference on Friday, December 13, to share recent congressional developments with the wider home care and hospice community. Val J. Halamandaris, President of NAHC, hosted the call. He was joined by Jeff Kincheloe, NAHC’s Vice President for Government Affairs; Bill Dombi, NAHC’s Vice President for Law; Richard Brennan, NAHC’s Vice President for Technology Policy and Government Affairs, and; Theresa Forster, NAHCS’s Vice President for Hospice Policy and Programs.
The teleconference served as an opportunity for NAHC staff to provide updates on a number of developments that occurred during ongoing legislative negotiations in Congress – many of which occurred after NAHC’s March on the Capitol earlier in the week. Specifically, the teleconference focused on the recently-reached budget agreement between Representative Paul Ryan (R-WI) and Patty Murray (D-WA) which passed the House earlier this week and will likely clear the Senate soon.
Other developments surround SGR legislation – or the “doc fix” – which saw action in both the House and the Senate. A three month delay in the scheduled 24 percent cut in Medicare physician payments was included in the budget deal. Congress intends to address a permanent fix to the flawed Medicare physician payment formula during the first three months of next year.
On the Senate side, the Senate Finance Committee held what NAHC’s Vice President for Hospice Policy and Programs Theresa Forster called, “an old-fashioned mark-up where members were able to bring up amendments” for inclusion in the permanent “doc fix” bill. Several of the amendments were very favorable for the home care and hospice community.
Below are the details on all of the developments that were discussed during the teleconference.
“We did get an agreement that many people thought was impossible… to fund the Federal Budget,” said NAHC President Val J. Halamandaris. “Most people believe that this signals a return to a more normal, cooperative process. The really significant thing is that both sides – Democrats and Republicans – got what they wanted out of this.” Specifically, Democrats were able to preserve Social Security, Medicare and Medicaid without any significant changes or modifications to any of those entitlement programs, while the Republicans were successful in preventing any new tax increases from being included.
Of greatest interest to the home health and hospice community is the fact that there were no new Medicare or Medicaid payment cuts and no home health or hospice copays,though the two percent Medicare sequestration cut remains in effect. However, the the two percent cut is not cumulative and will simply get readjusted each year. The two percent sequester cut was extended two years - from 2021 to 2023. In 2023 the sequester cut would be 2.9 percent for the first six months of the year and 1.1 percent for the last six months. This was done to extend more savings into the 10 year window for purposes of CBO scoring.
NAHC’s Vice President for Law, Bill Dombi stated that, “we’re assuming that [Congress] will pass the budget before going out for Christmas.” The House has already passed the budget and the Senate is scheduled to begin debate on it this week.
The Fostering Independence Through Technology (FITT) Act has been a major priority of both NAHC and its affiliated Home Care Technology Association of America (HCTAA) for some time. The legislation would expand the use of telehealth under Medicare by offering incentives to home health agencies who demonstrate the use of remote monitoring and communication technologies that serve rural and underserved urban communities.
During the Senate Finance Committee mark-up, Senator Thune (R-SD), the bill’s original sponsor, was able to insert the text of the legislation into the SGR bill as an amendment, which was passed by a voice vote.
The inclusion of the FITT Act is another positive development for the home care and hospice community. “We’ve been working on this piece of legislation for five years,” said HCTAA’s Executive Director Richard Brennan. “Then all of a sudden, with a voice vote, it has the potential to move towards becoming law.”
Mr. Halamandaris added of Senator Thune, “Mr. Thune is smart and intelligent and certainly cares a lot about home health providers – especially in his rural state.”
The Senate Finance Committee held an extensive mark-up of the SGR – or “doc fix” legislation where several key amendments for the home care and hospice community were considered and accepted. One such amendment of particular interest to hospices was introduced by Senators Carper (D-DE) and Enzi (R-WY) that would allow physician assistants to serve as attending physicians for hospice patients. Said Mr. Halamandaris during the teleconference, “Our proposal for hospice was included in the SGR fix, and we’re celebrating that, too.”
Although it did not come up for a vote in the Senate Finance Committee markup, by offering it as amendment Senator Schumer (D-NY) did signal that one of his top priorities in the New Year will be to see another NAHC-supported piece of legislation become law. The legislation, the “Home Health Care Planning Improvement Act," was introduced earlier in the year by Senators Schumer and Collins (R-ME) and would allow nurse practitioners, clinical nurse specialists, nurse midwives, and physicians' assistants to certify Medicare home health plans of care.
During the teleconference, Jeff Kincheloe, NAHC’s Vice President of Government Affairs, stated the importance of Senator Schumer making this a priority, stating that it is, “really good news for us. We now have 13 Senators and 88 House members. One of the things the sponsors have asked for is to keep up the pressure to get more cosponsors onto this bill.”
The rebasing issue was also discussed during the teleconference. And while NAHC and its allies were unable to stop the rebasing rule from going into effect, the home care and hospice community is well-positioned to see either a rollback or repeal of the detrimental rule in the early part of the New Year.
“We were half an inch away to getting a rebasing amendment included…But this puts us in a very good position for our January efforts,” said Mr. Dombi of the push to repeal the rebasing rule either in the budget or SGR legislation.
Added Mr. Halamandaris, “It has been a full court press and we are very well positioned in January if we continue to work together...[the rebasing rule] is nothing less than an effort to dismantle the home health benefit.”
While NAHC staff remains optimistic about seeing the rebasing rule overturned in January, there is still work to be done. “As Members of Congress go back into their home states, it’s a perfect opportunity to reconnect with them and keep the fire burning on this issue,” said Mr. Dombi. “When you have the Speaker of the House on your side, and the Senate Majority Leader and Senator Bob Dole on your side, we can make this happen, but you’ve got to keep the fires burning.”
Aside from the myriad of positive legislative updates that NAHC shared during the teleconference, the point was repeatedly emphasized that there is more to be done, and meeting with elected officials during their Christmas recess is the perfect opportunity to do so.
NAHC encourages all of its members to share resources on opposing the rebasing rule and additional Medicare cuts and copayments that are available on NAHC’s Legislative Action Network website with their elected officials during the recess.
“When you have advocates at the top of both parties supporting you,” said NAHC President Val J. Halamandaris as the teleconference was concluding. “They don’t agree on much, but they do agree on the importance of home health. It doesn’t hurt that we are fighting on the side of angels. That’s why we fight so passionately and why we have more success than most people generally do.”
To listen to the teleconference in its entirety, as well as access previous NAHC teleconferences, please click here.