HAN In DC – Latest News

Because the legislative and political process is ongoing, and because healthcare and hospice figure prominently into both, there is always something going on for us here at HAN. Below you’ll find news on current events as they relate to hospice, as well as tools and information that HAN has produced to keep you abreast of the goings-on in D.C.

Letter to CMS Regarding Access to Medicare Care Choices Model Demonstration (3/7/2016) NHPCO President and CEO Don Schumacher wrote Patrick Conway, Deputy Administrator for Innovation & Quality and CMS Chief Medical Officer, to voice concerns regarding the Medicare Care Choices Model (MCCM) demonstration. Despite widespread interest from the hospice, provider, and patient communities, enrollment in the program has been low.  NHPCO expressed concerns that the demonstration’s eligibility requirements – such as requiring enrollees to have a stand-alone Part D plan, or to have had two hospital admissions in the previous year – are too restrictive to allow for robust participation.  The letter identified several potential changes that would allow more individuals to participate in this important demonstration.

President’s Budget for Fiscal Year 2017 and the Hospice Community (2/10/2016). The White House released the President’s budget proposal for fiscal year 2017 on February 9, 2016. The Hospice Action Network and NHPCO will be monitoring Congressional and regulatory activity for developments on proposals that may impact hospice programs, patients, and their families.

NHPCO Submits Comment Letter to Senate Chronic Care Working Group (1/21/2016). On December 18, 2015, the Senate Finance Committee’s Chronic Care Working Group released a report outlining policies under consideration as a part of the committee’s effort to improve how Medicare treats beneficiaries with multiple, complex chronic illnesses. The proposal includes a policy recommendation to “carve-in” hospice to Medicare Advantage plans. NHPCO submitted a comment letter to the Working Group addressing its concerns over an carve-in of hospice to MA.

Senators Ask CMS to Test Payment Changes (7/30/2015). A letter signed by 27 U.S. Senators was sent to CMS Acting Administrator Slavitt this week. The letter, one of the focal points of HAN’s Advocacy Intensive, asks CMS to test any changes to hospice payment methodology. Thank you to the hundreds of Hospice Advocates who asked their Senators to join this letter!

PCHETA Introduced in the House (7/22/2015). The Palliative Care and Hospice Education and Training Act (H.R. 3119)–otherwise known as PCHETA–was introduced in the House of Representatives! Congressmen Engel (NY-16) and Reed (NY-23) are the lead sponsors on the bill, and Congressman Cleaver (MO-5) is an original co-sponsor. The NHPCO Public Policy Committee voted to support this legislation on June 18, 2015.

CMS Announces 141 Hospice Sites for MCCM Demo (7/20/2015). The Medicare Care Choices Model (MCCM) will provide a new option for beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, and HIV/AIDS who meet hospice eligibility requirements under the Medicare hospice benefit, to receive palliative care services from  the hospice providers who have been chosen to participate in the model while concurrently receiving services provided by their curative care providers.

Hospice Care Access Improvement Act Introduced in the House (7/13/2015). The Hospice Care Access Improvement Act of 2015 (H.R. 3037) calls for a 1 year demonstration project to test any payment methodology reform proposed by CMS. CMS shall select one Medicare Administrative Contractor (“MAC”) to conduct the demonstration program with all hospices under that MAC’s jurisdiction during the 1 year period. No later than 6 months after the completion of the demonstration program the Secretary shall submit to Congress a report containing the results of the evaluation, together with recommendations for such legislation and administrative action as the Secretary determines appropriate. This legislation also contains a number of program integrity provisions long-supported by the hospice community. H.R. 3037 is lead by Congressmen Tom Reed (NY-23) and Mike Thompson (CA-5).

HAN Advocacy Intensive 2015 is Underway! (7/13/2015) Nearly 300 Hospice Advocates from across the country, representing 200 Congressional districts, converge on Capitol Hill. They will spend today in a series of policy and storytelling sessions to prepare them for meetings with their Members of Congress on Tuesday, July 14. Advocates at home can also get involved through the Virtual Hill Day feature on Tuesday.

Care Planning Act Introduced in Senate (6/10/2015). Senators Mark Warner (VA) and Johnny Isakson (GA) introduced the Care Planning Act (S. 1549) in the U.S. Senate. The Care Planning Act is designed to give people with serious illness the freedom to make more informed choices about their care with the help of an interdisciplinary team of healthcare professionals, and the power to have those choices honored.

NHPCO Health Policy Update on “Doc Fix” (3/23/2015). For the past week, details have been emerging about a House negotiated package that would end this cycle and permanently correct the physician pay formula. The NHPCO Health Policy Team updates providers on this recent congressional activity.

President’s Budget for Fiscal Year 2016 and the Hospice Community (2/5/2015). The White House released the President’s budget proposal for fiscal year 2016 on February 2, 2015. The Hospice Action Network and NHPCO will be monitoring Congressional and regulatory activity for developments on proposals that may impact hospice programs, patients, and their families.

Nine Minutes to Understand What to Expect in 2015 (1/8/2015): The Hospice Action Network has created a short video that lays out the policy challenges and opportunities we see for hospices in 2015, and what hospices can do to prepare for them.

Hospice Compliance/Regulatory Requirements, with Medicare Reimbursement Changes 2009-2016 (PDF).  With multiple Medicare reimbursement reductions, a series of costly regulatory changes, and hospice payment reform looming, hospices are facing a perfect storm.  Click above to access a timeline version of the compliance, regulatory, and reimbursement changes happening in the hospice community. Updated 10/2014

President Obama signs IMPACT Act into Law (10/7/2014).  President Obama signed into law the “Improving Medicare Post-Acute Care Transformation Act of 2014” (IMPACT Act) that includes provisions creating greater oversight and increased transparency within the hospice community. The National Hospice and Palliative Care Organization heralds the passage of this legislation and the additional oversight it will bring to end-of-life care providers.

IMPACT Legislation Passed by Congress (9/19/14).  The U.S. House of Representatives and Senate passed theImproving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), legislation which includes hospice integrity provisions that are backed by the hospice community.  The National Hospice and Palliative Care Organization supports this legislation and the additional oversight it will bring to end-of-life care providers.

Commentary on Media Coverage (8/21/14).  An article was published by The Washington Post (“As more hospices enroll patients who aren’t dying, questions about lethal doses arise”) which uses anecdotal information to allege that terminally ill patients died due to improper use of prescribed medications. Click on the link above to read NHPCO’s response.   

NHPCO Offers Comments on Research Published in Journal of Palliative Medicine (8/7/14).  Research published in the Journal of Palliative Medicine (Volume 17, Number 10, 2014) takes a close look at hospice patients that discontinue hospice care before their deaths – known as live discharges.

Comment from NHPCO on a Washington Post Article (8/6/14). The Washington Post article, “Rising rates of hospice discharge in U.S. raise questions about quality of care,” looks at the issue of live discharges.  Read the NHPCO response above.

Hospice Community Applauds New Legislation to Promote Appropriate Oversight (8/4/14).  Legislation requiring more timely surveys of Medicare-certified hospice care programs was introduced on Friday, August 1, before the House of Representatives adjourned for the August recess.  Led by Congressmen Tom Reed (R-NY) and Mike Thompson (D-CA), the Hospice Opportunities for Supporting Patients with Integrity and Care Evaluations (HOSPICE) Act, HR 5393, is being well-received by the hospice community.

How to Host the Perfect Site Visit! HAN has created a comprehensive series on how to host a site visit with a Member of Congress. Whether you’ve never hosted a Senator or Representative, or even if you’ve done it before, this 5-part series on how to host a successful visit is a great resource for in-district advocacy.  Check it out!

CMS issues revised, interim guidance on Hospice and Part D (7/18/14). Since March, the National Hospice and Palliative Care Organization and Hospice Action Network have been working with the hospice community and many Congressional champions to halt implementation of a Medicare Part D policy that resulted in dying patients unable to get necessary medications under their Part D benefit. These efforts have been successful. Click above to read our press release on the new guidance. 

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