The home care and hospice community must continue to be involved and present a unified message as lawmakers work to address the impending “fiscal cliff.” During the post election “lame duck” session, Congress will be grappling with how to reduce burgeoning deficits and offset the costs of fixing the flawed Medicare physician payment formula, among a host of other fiscal issues. If nothing is done about the “physician fix” by the end of the year, physician payments will drop by 27 percent.
NAHC has scheduled a “March on Washington” lobby day for Wednesday, December 5, and Thursday, December 6, and we are asking you to join us—in person, if possible, to visit your Senators and Representatives on Capitol Hill, or virtually using the NAHC Legislative Action Network and other means to contact them back in the states and districts. The message to lawmakers is “Oppose Medicare home health copays and payment cuts.” For hospice—“Reject efforts to cut the Medicare hospice benefit.”
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 Congressional Budget Office put forth a 10 percent home health copay as one of its budget options for deficit reduction, a proposal that received support from the Republican Study Committee. 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 September 2011 deficit reduction plan included a $100 home health copay for episodes not preceded by a hospital or nursing home stay, beginning in 2017 for newly eligible Medicare beneficiaries. Further cuts in home health payments have also been proposed in these plans.
Hospice patients and providers could also suffer significantly under some deficit reduction proposals. Medicare hospice spending per beneficiary averages approximately $10,000 annually; the uniform 20% copay proposal, if applied to hospice, could impose an average copay of about $2,000 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.
Attend the December 5-6 March on Washington: We will kick off the lobby day with a luncheon briefing at NAHC’s Frederick Douglass Museum and Hall of Caring Americans at 320 A Street N.E. in Washington, DC on Wednesday, December 5 at 12:30 PM. NAHC staff will brief attendees on the latest developments in Congress and provide background materials for their visits with legislators. Attendees will fan out across Capitol Hill to visit with their Members of Congress on Wednesday afternoon, December 5, and Thursday morning December 6. Congress is scheduled to leave town Thursday afternoon.
Please register for the D.C. Lobby Day by contacting Jeff Kincheloe at 202-547-7424 or by email at firstname.lastname@example.org. If you plan to attend the lobby day, please call the offices of your Senators and Representative in advance to set up meetings. You can locate the offices and contact information for your elected officials on the NAHC website by clicking here: Contact Your Elected Officials.
Participate Virtually: If you can not attend the D.C. Lobby Day, you can still help by sending a message using the NAHC Legislative Action Network (LAN). Click here for a sample message opposing home health copays and payment cuts. The message will be more impactful if you personalize it with your background and experience and describe the harm that copays and payment cuts will cause patients and providers in your state and district. For hospice messages, click here and here.
You may also deliver the message by phone or by arranging a meeting with the Member of Congress or their staff back in the state or district. When calling, ask the receptionist to connect you with the staffer who handles health care issues. Another option is to organize a conference call, or communicate using new technology such as Skype, with the health staffers for your Senators and Representative and members of the home care and hospice community. For talking points on home health copays, go here; for payment cuts, go here. For hospice, go here.