Home care groups rally for IPS moratorium
Gathering in Washington, DC, in September, the country's leading home care groups joined forces in a final effort to convince Congress to impose a moratorium on the Medicare home health interim payment system (IPS) before it adjourns next month. The two-day rally was organized by the National Association of Home Care of Washington, DC (NAHC), the American Federation of Home Health Agencies of Silver Spring, MD, and the Home Care Association of America of Washington, DC.
Events culminated with a rally on the grounds of the U.S. Capitol, where Sen. Christopher Bond (R-Missouri) told the assembled crowd that Congress has an obligation to end the "insane system" that the Health Care Financing Administration (HCFA) is currently using to reimburse home health agencies.
Specifically, Bond urged Congress to pass the Medicare Home Health Beneficiary Protection Act of 1998 (S. 2354). That bill, which Bond introduced July 24, would not only place a moratorium on IPS, but would also freeze home health agency per-visit cost limits at 1996 levels and address the automatic 15% reduction in home health payments that are scheduled to take effect Oct. 1, 1999.
"It is imperative that Congress act now," Bond said. "The action of a federal bureaucracy, HCFA, has forced thousands of Medicare beneficiaries to search for a new source of care," he said, adding, "I am highly concerned about this punitive IPS which is driving honest quality providers out of business, many of which are small businesses in underserved rural and urban areas."
Also addressing the rally were roughly a dozen members of the House, including Reps. Van Hilleary (R-TN) and Nick Rahall (D-WV). Hilleary and Rahall have introduced legislation, the Homebound Elderly Relief Opportunity Act of 1998 (HR 4404), that would make the moratorium on IPS budget-neutral.
NAHC used the event to unroll a two-mile-long petition. The petition was signed by more than 10,000 home care providers and patients, state and national aging organizations, disability groups, churches, and state officials who support IPS reform.
NAHC and other home care groups maintain that more than 1,100 home health agencies have either closed or withdrawn from the Medicare program since the beginning of the year. "Without home health services," said NAHC president Val J. Halamandaris, "thousands of people will be forced to prematurely enter nursing homes at a higher cost to their families and state Medicaid programs."
Certain states have been particularly hard hit, argues NAHC. According to an ongoing survey of state home care associations that have been monitoring closures throughout the year, 64 home health agencies have closed in California, while 165 have closed in Louisiana, and 450 have closed in Texas.
In addition to the press conference, hundreds of home care advocates made visits to Congressional offices to make their case for a moratorium on IPS. "The next few weeks will be a crucial period," an aide to Sen. Bond told Hospital Home Health, "because Congress is going to be busy trying to pass the remaining appropriations bills and dealing with the fallout over the Starr Report. It is going to be a very hectic couple of weeks."
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