NAHC Lobby Day Set for December 5 and 6 for Home Care

National Association for Home Care & Hospice (NAHC) wants to remind the home care and hospice community to be involved and present a unified message as lawmakers work to address the impending “fiscal cliff.” Congress is 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.

As mentioned in earlier posts, NAHC scheduled a “March on Washington” lobby day for Wednesday, December 5, and Thursday, December 6, and asks you to join — in person, if possible, to visit your Senators and Representatives on Capitol Hill. The call to action is to contact your representatives and the message is to “Oppose Medicare home health copays, payment cuts, and changes to the benefit.” For hospice — “Reject efforts to cut the Medicare hospice benefit.”

Many state home care associations and industry leaders made the trip to Washington, D.C. on behalf of the industy to meet with key members of Congress including leaders of both parties, MedPAC, and the Centers for Medicaid and Medicare (CMS).

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.

To Take Action Virtually and In-District: Now and through December 6, you should make contact with your elected officials through email, phone, letters, and by making appointments with Congressional staff at home in the district office.

To Attend In Washington, D.C.: NAHC will kick off the lobby day with a luncheon briefing at the Frederick Douglass Museum and Hall of Caring Americans at 320 A Street N.E. in Washington, D.C. 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.

To register for the D.C. Lobby Day contact Jeff Kincheloe at 202-547-7424 or by email at If you plan to attend the lobby day in person in Washington, D.C., please call the offices of your Senators and Representative in advance to set up meetings.