Action Alert

Contact Members of Congress to Oppose Any Cuts to Home Health and Hospice Services

Background

NAHC LAUNCHES GRASSROOTS CAMPAIGN TO ENSURE ADEQUATE AND APPROPRIATE PAYMENT FOR HOME HEATLH AND HOSPICE SERVICES

President Bush’s Fiscal Year 2009 budget proposal delivered to Congress seeks almost $180 billion in cuts to Medicare over the next five years, more than twice the savings proposed last year but rejected by Congress thanks in part to the aggressive grassroots efforts of the National Association for Home Care & Hospice. The bulk of the savings would come from a multi-year freeze in reimbursement rates for most health care providers and from cutting hospital payments.

The President’s budget would take $11.03 billion out of Medicare home health spending by freezing payments over five years (FY09-FY13) and instituting a permanent cut in the inflation update of 0.65 percent thereafter. Earlier this year, the Medicare Payment Advisory Commission (MedPAC) recommended a one year home health payment freeze. The President’s budget makes no provision for reinstating the 5 percent add-on payment for home health services in rural areas, which expired January 1, 2007.

The President’s budget would cut hospice payments by $5.14 billion over five years through a three-year freeze and a permanent reduction of 0.65 percent to the hospice update beginning in FY12.

The Centers for Medicare & Medicaid Services (CMS) administratively has promulgated a 2.75 percent across-the-board rate reduction for home health services for 2008, 2009, and 2010, as well as a 2.71 percent cut for 2011. Over the next five years (09-13) this provision would reduce outlays for home health by $7.59 billion. This reduction is based on an unfounded allegation by CMS that case mix weights have increased without attendant changes in patient characteristics, referred to by CMS as “case mix creep or upcoding.” Senators Susan Collins (R-ME) and Robert Casey (D-PA) and Representatives Jim McGovern (D-MA) and Walter Jones (R-NC) have introduced the “Home Health Care Access Protection Act” (S. 2181/H.R. 3865) to block implementation of these regulatory cuts and require a transparent new process and criteria for evaluating case mix changes.

The President is also proposing through regulation to cut hospice payments by $2.29 billion by eliminating the budget neutrality adjustment for the hospice wage index.

If not stopped, the combination of the President’s home health payment freeze and CMS regulatory payment cuts would reduce Medicare home health payments by $18.62 billion over five years. The combination of the President’s hospice freeze and CMS regulatory cut would reduce Medicare hospice payments by $7.43 billion over five years.

NAHC has launched an aggressive campaign and is asking Members of Congress to: (1) reject home health and hospice payment cuts and reinstate the 5 percent rural add-on; and (2) block the CMS regulatory cuts in home health and hospice payments. Members of Congress are also urged to cosponsor the “Home Health Care Access Protection Act” (S. 2181/H.R. 3865).

NAHC has prepared the following tools for this grassroots campaign—including sample grassroots letters for home health and hospice, fact sheets, and impact data—to assist home health and hospice advocates as they communicate with their Members of Congress.

NAHC has prepared the following tools for this grassroots campaign--including a sample grassroots letter, fact sheet, and impact data—to assist home health providers as they communicate with their Members of Congress.

Home Health Action Alert

Contact Members of Congress to Oppose Any Cuts to Home Health Payments, Reinstate the Rural Add-On, and Cosponsor H.R. 3865 and S. 2181

GRASS ROOTS LETTER TO CONGRESS

TAKE ACTION N0W!

HOME CARE GRASS ROOTS LETTER TO CONGRESS --

HOUSE - Send a message to your Representative to oppose Medicare Home Health cuts, reinstate the 5 percent rural add-on payment for home health services in rural areas, and cosponsor H.R. 3865 the “Home Health Care Access Protection Act.”

To View a List of Representatives Who Have Co-Sponsored H.R. 3865
Click Here (As of 4/23/08)

SENATE - Send a message to your Senators to oppose Medicare Home Health cuts, reinstate the 5 percent rural add-on payment for home health services in rural areas, and cosponsor H.R. 3865 the “Home Health Care Access Protection Act.”

To View A List of Senators Who Have Co-Sponsored S. 2181
Click Here (As of 4/22/08)

FACT SHEET

1. Ensure Adequate and Appropriate Payment For Medicare Home Health Services

2. Home Health Care Access Protection Act (H.R. 3865 and S. 2181)

IMPACT DATA

State Medicare Home Health Projected Losses from the President's Fiscal Year 2009 Proposed Budget

Percent of Home Health Agencies, By State, with NEGATIVE Margins in 2008, 2009, 2010, 2011, 2012 and 2013 if the 5-year Market Basket Freeze and CMS Case Mix Adjustment were implemented

HOUSE AND SENATE CONTACT INFORMATION

To find out the name of your Representative and Senators click here.

To view contact information for Representatives and Senators click here. (updated 5/1/08)

NAHC has prepared the following tools for this grassroots campaign--including a sample grassroots letter, fact sheet, and impact data—to assist hospice providers as they communicate with their Members of Congress.

Hospice Action Alert

Contact Members of Congress to Oppose Cuts to Hospice

GRASS ROOTS LETTER TO CONGRESS

TAKE ACTION N0W!

HOSPICE GRASS ROOTS LETTER TO CONGRESS --

HOUSE - Send a message to your Representative to oppose Medicare Hospice Cuts

SENATE - Send a message to your Senators to oppose Medicare Hospice Cuts

FACT SHEET

1. Preserve the Full Hospice Market Basket Update and the Budget Neutrality Adjustment to the Hospice Wage Index

2. Duke Hospice Cost Savings Study

IMPACT DATA

State-by-State Projected Losses in the Medicare Hospice Program as proposed by the President's Fiscal Year 2009 Budget.