Washington Update: Delivering Policy Messages to Congress During March on Washington
March 23, 2015 05:32 PM
The the National Association for Home Care and Hospice (NAHC) 2015 March on Washington Conference comes at a critical time for advocates to deliver their message to Congress about the importance of home care and hospice, a panel of policy experts said to conference attendees on Sunday. Providers already face new regulations that could challenge their ability to provide high-quality, cost-effective care. In addition, this will be an action-packed week in the U.S. Congress on health care issues. The House of Representatives has scheduled a vote this Thursday on legislation to permanently fix the Medicare Sustainable Growth Rate (SGR). Furthermore, both chambers of Congress will consider their respective budget resolutions, with proposed changes to entitlements and the health care system. The SGR bill and the budget resolutions may serve as legislative vehicles to address some of NAHC’s most pressing issues.
Former U.S. Senator Mark Begich, who recently joined NAHC as Vice President for Policy and Business Development, highlighted the importance of advocacy during the March on Washington. Begich said the March on Washington comes at an “exciting time” and called it an opportunity “to deliver a message to Washington, Senators, and Congressmen, of how important home care and hospice is, and why everything you do every day makes a difference in peoples’ lives.” Sometimes, Begich said, members of Congress “lose touch” with the importance of home care and hospice. “That’s why you’re here. Make sure they hear the message, and deliver to them the importance of home care and hospice in their communities and why they need to do the right thing.”
Colin Roskey, Esq., Alston & Bird, LLP, and Counsel to NAHC, said bipartisan movement on the SGR bill could finally provide a solution, which has long eluded Congress. The habit of Congress passing an annual patch, Roseky said, rather than a long-term solution has been “a cycle of health care violence” and “unfair” to many stakeholders.
As NAHC previously reported, the SGR bill as currently negotiated will cost roughly $200 billion but it will only offset $70-80 billion of the total cost. NAHC has learned that the offsets would affect both beneficiaries and providers. For beneficiaries, the changes would include increased costs for Medicare enrollment through means testing of premiums, restrictions on first-dollar payment of deductibles, and copayments through Medigap policies. Providers of services would be impacted through a reduction in the annual rate increase, among other possibilities. For the 2018 inflation update, the Market Basket Index (MBI), would be set at 1% - the equivalent of a 1 point reduction based on an estimated 2.5% MBI and a 0.5% Productivity Adjustment. Home health, hospice, and other Post-Acute Care providers would share the same rate reduction.
Roskey said, when meeting with members of Congress, advocates should emphasize that NAHC members have already made significant sacrifices, with a third year of rebasing and expiration of the rural add-on at the end of this year.
William A. Dombi, Esq., Vice President for Law, said NAHC is working to “mitigate” the impact of the cuts from the offsets, because providers can’t afford more cuts after rebasing. Dombi said, based on the current plan, Post-Acute Care providers plus hospice will take a $15 billion cut; hospitals will also take a $15 billion cut.
“The 1-point basket update translates into $3.4 billion in cuts over a 10-year period of time, “ Dombia said. “And they’re permanent. They keep growing and growing. And on the hospice side, well over $2 billion of impact on payments to hospices.”
With home health agencies going through two more years of rebasing after 2015, Dombi said they “can’t afford any more cuts.” As a result, Dombi said NAHC’s first priority is to address the potential cuts by either removing them or at least moving them to a later date.
“If we can’t get it removed, we’ve been trying to move it to 2020,” Dombi said. “If we can’t get it to 2020, what we’re trying to do is phase it in – a little bit each year starting in 2018. Originally, just so you understand this part, they wanted to cut us starting in 2016. So they have already moved a bit in that regard.”
NAHC’s second priority with the SGR legislation is trying to include a 2-year extension of the Medicare Home Health Rural Add-on, which is set to expire at the end of this year. Dombi said the Rural Add-on extension is on the “possibility list” of provisions to add. Dombi encouraged NAHC members to raise this issue with their members of Congress.
The final issue NAHC is working on for possible inclusion in the SGR bill is a legislative solution to the face-to-face encounter rule.
The panel said advocates should also encourage members of Congress to address home care and hospice priorities as part of the Budget Resolution. Even though the policy proposals in the budget proposal do not have the force of law, amendments to the budget resolution are a good opportunity to message on key issues.
Other issues the panel encouraged advocates to raise with Congress include:
· Cosponsor the Nurse Practitioner bill
· Make a statement on the Congressional Record, or using social media, in support of home care and hospice
· Oppose the imposition of a surety bond on home health agencies as a pay-for
You can access all of the legislative campaigns at NAHC’s Legislative Action Network.
NAHC also encourages those unable to attend the March on Washing to reach out to their members of Congress regarding these issues through NAHC’s Legisaltive Action Network.