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NAHC Report: Issue# 2409, 4/10/2014
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House Passes the Ryan Budget
CMS Holds Special Open Door Forum on Hospice and Medicare Part D
For Your Information: NAHC Announces the 2014 Financial Management Conference & Exposition
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House Passes the Ryan Budget
Budget framework includes steep cuts to Medicare and Medicaid and a repeal of the Affordable Care Act

The House of Representatives recently passed the latest version of the Republican budget authored by Rep. Paul Ryan (R-WI). The budget framework, which aims to achieve a balance between federal spending and revenues in ten years, passed the House by a mainly party-line vote of 219 – 205. Twelve Republicans joined with all of the chamber’s Democrats in opposing the budget, which aims to balance the budget by cutting more than $5 trillion in federal spending over the next ten years – mostly from social programs.

NAHC has expressed concern in the past that some of the provisions contained in the Ryan budget could lead to access to care issues for disabled, and elderly patients under Medicare and Medicaid.

Specifically, NAHC opposes efforts to shift Medicaid to a block grant program, which would limit the federal contribution and allow states to cap enrollment and services when a certain expenditure point is reached. And it advocates that Medicare should continue to guarantee specific benefits and believes that privatizing the program through vouchers or premium subsidies would place many seniors at risk.  The Leadership Council of Aging Organizations strongly opposes the Medicare and Medicaid proposals in this budget.

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CMS Holds Special Open Door Forum on Hospice and Medicare Part D

CMS held a Special Open Door Forum (ODF) on the topic of Medicare Part D and Hospice on April 8, 2014.  This ODF was an opportunity for providers to ask questions of CMS subject matter experts on the Part D Payment for Drugs for Beneficiaries Enrolled in Hospice – Final 2014 Guidance.  This guidance was released on March 10, 2014 and is effective May 1, 2014.  Because previous Part D guidance was ambiguous, and there were no objective criteria for sponsors to use in making Part A vs. Part D coverage and payment decisions, the policy will be applied prospectively.

During the ODF CMS reminded providers that, per statute, Medicare excludes from coverage under Part D any drugs that are available under Parts A or B.  Since hospice is a Part A benefit, drugs covered under the hospice benefit for an individual can not be covered under Part D. 

In order to avoid duplicate payments for drugs covered under hospice or waived through the hospice election, CMS directed Part D sponsors to place beneficiary-level prior authorization (PA) requirements on all drugs presented to Part D for payment for beneficiaries who are receiving hospice services.  More detailed information is found in the Part D Payment for Drugs for Beneficiaries Enrolled in Hospice.

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NAHC Announces the 2014 Financial Management Conference & Exposition
This year’s conference is being held July 13-15 at the Chicago Marriott Downtown in Chicago, IL

This year’s Financial Management Conference & Exposition will take place July 13-15 in Chicago, a hub for business and finance in the middle of the country. The National Association for Home Care & Hospice (NAHC) and its affiliate Home Care & Hospice Financial Managers Association (HHFMA) invite you to join them for three days of sessions and speakers that will offer new skills, techniques, and tools for financial mangers from the home care and hospice community.

Attendees will hear from industry experts whose knowledge and know-how are second to none. They’ll share insight into how to manage cases, access capital, and ensure compliance. This year’s Financial Management Conference will bring a special focus on technology - a key issue as home care takes on a central role in the evolving integrated health system based on patient-centered, high-quality, cost-effective care.

Register today to join your peers and colleagues in Chicago for one of NAHC’s most popular and informative conferences of the year.

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