Bill moves forward with unwelcome additions
The Medicare Hospice Benefit Amendments of 1997, contained in HR 521 and SB 734, have been incorporated into budget reconciliation bills approved by both houses of Congress in June. The hospice amendments would restructure the hospice benefit periods to include two 90-day periods and an unlimited number of 60-day periods; clarify requirements for employing hospice medical directors and for physician certification of terminal illness; and create new rural waivers for certain required services. Other language in both houses’ budget bills would allow Medicare to continue paying hospices directly for care of enrollees of Medicare risk plans that choose not to assume full financial risk for hospice care and mandate that hospice claims be paid on the basis of the location where the service is provided not the location of the hospice’s billing office.
The House, but not the Senate, adopted a provision which would lop 1% off hospices’ annual statutory rate increases, based on the hospital market basket inflationary rate, for fiscal years 1998 to 2002, to reduce hospice reimbursement 1% below the mandated market basket inflationary raises for fiscal years 1998 through 2002. It also requires the Secretary of Health and Human Services to collect cost data from hospices and reinstate hospice Medicare cost reports. The Senate added a last-minute provision with additional language on waiver of liability for hospice coverage.
The National Hospice Organization (NHO) in Arlington, VA, opposes the rate reduction and the Senate’s waiver provision, which it views as singling out hospice unnecessarily, and was working with members of Congress to explain its opposition, reports Kathy Gavett, NHO’s director of state and government relations. Those provisions that are different in the two bills will be ironed out in a Conference Committee, which was expected to be named in early July. The amendments sponsored by the hospice community and contained in both bills seem to be a safe bet to be included in the budget package that goes to the President.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content