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NAHC Report: Issue# 2394, 3/18/2014
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SGR Proposals Move Forward in the House and Senate
CMS Launches “Concurrent Care” Demonstration
For Your Information: Medicare Hospice Education Sessions Announced for this Year’s March on Washington
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SGR Proposals Move Forward in the House and Senate
SGR Measure Passes in the House that Ties Repeal to a Delay in the ACA’s Individual Mandate; Senate Finance Committee Chairman Ron Wyden Introduces Legislation that would Repeal the SGR Formula without Requiring Offsets

Late last week – just prior to adjourning for a weeklong recess – the House of Representatives passed a bill that repeals the sustainable growth-rate formula (SGR) and also includes a five-year delay of the financial penalties for people who don't purchase health insurance, known as the “Individual Mandate,” that was included in the Affordable Care Act (ACA). The measure – officially known as the, “SGR Repeal and Medicare Provider Payment Modernization Act,” passed the House on a vote of 238 – 181. 12 Democrats joined their Republican colleagues in voting for the measure.

Given that the House bill ties repealing the SGR to delaying yet another provision of the ACA, the measure is likely dead on arrival in the Democratic-controlled Senate. However, Senator Ron Wyden (D-OR), the chairman of the Senate Finance Committee, which has jurisdiction over Medicare, introduced his own SGR repeal bill on March 13, 2014. Chairman Wyden’s bill would repeal the broken SGR formula, though would not tie its repeal to delaying the Individual Mandate. Senator Wyden’s bill    would not require offsets to pay for SGR repeal.

“If Congress fails to fully repeal the flawed Medicare payment formula now, I believe there will be cuts to other providers, hospitals, home health care providers, drug companies, skilled nursing facilities,” Senator Wyden said while introducing his bill on the Senate floor. “We'll be able to accomplish what we were sent here to do - find a way to do what's best for seniors and the doctors who care for them.”

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CMS Launches “Concurrent Care” Demonstration
30 Hospice Sites to Test Palliative, Curative Care Model

On March 18, 2014, the Centers for Medicare & Medicaid Services (CMS) announced the launch of the “concurrent care” demonstration authorized by the Patient Protection and Affordable Care Act (PPACA).  Under the “Medicare Care Choices Model” (MCCM), as many as 30 Medicare-certified hospices will be selected to provide palliative support services in the form of routine home care (RHC) and in-home respite to patients with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS who meet hospice eligibility requirements. 

The patients will concurrently receive services provided by their curative care providers.  Hospices selected for the three-year demonstration will receive $400 per beneficiary per month (PBPM) to provide the palliative care services; to be selected the hospices must be Medicare-certified hospice and able to demonstrate experience providing care coordination and/or case management with a network of various types of healthcare providers, as well as shared decision-making to beneficiaries prior to electing the Medicare hospice benefit in conjunction with their referring providers/suppliers.

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Medicare Hospice Education Sessions Announced for this Year’s March on Washington

The Home Care and Hospice community is at a critical point as new rules are being considered on Capitol Hill that could affect how home care and hospice organizations operate and pose a significant challenge to the mission to serve America’s aged, disabled, and ill.

Join NAHC, your peers and colleagues at this year’s March on Washington to make home care and hospice the center of health care in our country.

Along with legislative meetings and advocacy, this year’s March on Washington will have compelling educational sessions to provide home care and hospice advocate with the tools, skills and information that they need to make the strongest case possible for preserving access to quality home care and hospice services for all who need them.

This year’s Educational Tracks include:

  • Medicare Home Care
  • Medicare Hospice
  • Medicaid Home Care, and,
  • Private Duty

Some of the Educational Sessions for the Medicare Hospice track include:

  • Program Integrity and Beyond
  • Answers from the Experts: Panel on the Medicare Hospice Program
  • Revisions to the Hospice Cost Report — the Why, What, and How-to of Expanded Data Collection Under the Affordable Care Act (ACA)
  • Medicare Hospice Policy Roundup

To view all of the Medicare Hospice tracks, please click here.

To register to attend this year’s March on Washington, please click here.

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