Final Push for Co-Signers of House Letter to President Seeking Permanent Restoration of Hospice BNAF

Call for More Signatures Ends Friday, May 15

Representatives Chris Van Hollen (D-MD) and Ginny Brown-Waite (R-FL) plan to collect all of the promised signatures on Friday, May 15 and send the letter www.nahc.org/NAHC/CaringComm/eNAHCReport-mbrs/Attachments/nr040209_hospicevanhollen.pdf, asking President Obama to permanently restore the budget neutrality adjustment factor (BNAF) to the hospice wage index. They want the President to get the message that members of the House of Representatives recognize the great danger the cut in hospice reimbursement will be to the hospice industry and the thousands of terminally ill being served in their communities.

There are currently 126 co-signers of the Van Hollen/Brown-Waite letter in the House. Click here to go to the National Association for Home Care & Hospice (NAHC) Legislative Action Network (LAN) for the complete listing, if your representative is not there, please ask that their signature be added. NAHC urges all hospices to ask their Member of the House to sign on to the letter. As many signatures as possible are urgently needed by this Friday!

US Senate Co-signers Also Sought for Hospice BNAF Restoration Letter to Obama Senators Arlen Specter (D-PA), Tom Harkin (D-IA), Pat Roberts (R-KS) and Ron Wyden (D-OR) have written a Dear Colleague sign-on letter similar to that in the House of Representatives asking President Obama to make permanent restoration of the budget neutrality adjustment factor (BNAF) to the Medicare Hospice wage index. They are also seeking co-signers for that letter. Click here for letter.

Thanks to the efforts of hospice advocates in Congress, the American Recovery and Reinvestment Act of 2009 contained a provision postponing elimination of the BNAF until Oct. 1, 2009 to give the Obama Administration time to reconsider the appropriateness of this cut. However, if Congress does not act, CMS will again begin the 2010 phase-out of 75% of the BNAF with complete elimination in 2011, resulting in a hospice cut in reimbursement.

The elimination of the BNAF creates a serious risk of loss of access to hospice care. The Medicare Payment Advisory Commission (MedPAC) has reported that the average hospice margin was 3.4% in 2005; elimination of the BNAF decreases hospice reimbursement by 4 percent. There is a very real danger of putting community hospices out of business resulting in a lack of access to the hospice benefit, particularly in rural areas.

MedPAC’s March 2009 Report to the Congress contained a set of recommendations that included changing the hospice payment system by 2013. However, MedPAC is relying on CMS to gather the data needed to ensure responsible analysis prior to making any refinements/changes. CMS is in the process of collecting data on hospice services and costs. MedPAC has not recommended a cut in the hospice benefit.

The Medicare budget also will suffer through the loss of hospice care. A recent Duke University study showed that patients who died under the care of hospice cost the Medicare program an average of about $2,300 less compared with those that did not.

NAHC urges everyone in the hospice community to ask their senate members to cosign the letter to President Obama. It is very important to do this today. As many signatures as possible are needed within the next couple of weeks to ensure the President understands the urgency for him to act.

If your senator is not included on the following list, please follow steps below to make contact:

Arlen Specter (D-PA)

Tom Harkin (D-IA)

Ron Wyden (D-OR)

Pat Roberts (R-KS)

Sam Brownback (R-KS)

Susan Collins (R-ME)

Herb Kohl (D-WI)

Russ Feingold (D-WI)

Bob Casey (R-PA)

Tim Johnson (D-SD)

John Kerry (D-MA)

For contact information for your Senator, click here . When calling, ask the receptionist to connect you with the staffer who handles Medicare issues. If the staffer says he or she has not seen the Dear Colleague and sign on letter from Specter/Harkin/Wyden/Roberts, offer to forward it (View the Dear Colleague letter by clicking here ).

You may send a message to your members of Congress asking them to sign onto the Specter/Harkin/Roberts/Wyden letter in the Senate and if your Representative has not yet joined the Van Hollen/Brown-Waite Dear Colleague letter, through the NAHC Legislative Action Network (NAHC LAN) by clicking here .

What epidemiological investigations are taking place in response to the recent outbreak?

April 29, 2009, 10:55 PM ET

CDC works very closely with state and local officials in areas where human cases of H1N1 (swine flu) infections have been identified. In California and Texas, where EpiAid teams have been deployed, many epidemiological activities are taking place or planned including:

Active surveillance in the counties where infections in humans have been identified;
Studies of health care workers who were exposed to patients infected with the virus to see if they became infected; Studies of households and other contacts of people who were confirmed to have been infected to see if they became infected; Study of a public high school where three confirmed human cases of influenza A (H1N1) of swine origin occurred to see if anyone became infected and how much contact they had with a confirmed case; and Study to see how long a person with the virus infection sheds the virus.