The spring and summer months of 2017 were rife with partisan debates over efforts to repeal and replace the Affordable Care Act. Because of the rancorous atmosphere on Capitol Hill, it might be hard to believe there is healthcare legislation that both Republicans and Democrats agree on. Members from both parties of the 115th Congress have supported legislation that will positively affect home healthcare and hospice services. Two bills that received broad bipartisan support in the current and previous Congresses are poised to make important strides in the 115th Congress.
The Home Health Care Planning and Improvement Act (S. 445/H.R. 1825), introduced by Senators Susan Collins (R-ME) and Ben Cardin (D-MD) and Representatives Chris Collins (R-NY) and Jan Schakowsky (D-IL), would allow advanced practice nurses (APRNs) to certify eligibility for Medicare beneficiaries and make changes to home healthcare plans of treatment. APRNs currently satisfy Medicaid's face-to-face requirement but are prohibited from signing home healthcare plans and certifying patients for the Medicare benefit. Because of this, patients with limited access to a physician face delays for the home healthcare services they need.
In the 114th Congress, the bill had 207 Representatives (119 D, 88 R) and 53 Senators (35 D, 17 R, 1 I) to support the legislation. At the time of writing this, the bill was supported by 108 Representatives (64 D, 44 R) and 36 Senators (24 D, 11 R, 1 I). The Visiting Nurse Associations of America (VNAA) and other stakeholders are actively working to secure a committee hearing and markup before the end of the year-both of which are necessary steps to pass the legislation.
Another bill, which enjoyed similar support and cleared an important procedural hurdle in the 114th Congress, is the Palliative Care and Hospice Education and Training Act (PCHETA) (H.R. 1676/S. 693). Introduced by Representatives Eliot Engel (D-NY) and Tom Reed (R-NY) and Senators Tammy Baldwin (D-WI) and Shelley Moore Capito, PCHETA would:
* Authorize funding for education, training, and professional development for palliative care,
* Authorize funding for public outreach and education through a National Palliative Care Education and Awareness Campaign, and
* Direct the National Institutes of Health to develop a research strategy to address quality of care and quality of life for patients with serious illness.
PCHETA received a full Energy and Commerce Committee hearing in the 114th Congress, which is an important step before a bill can be voted on by the Committee and sent to the full House of Representatives for consideration. VNAA and its partners in the Patient Quality of Life Coalition are actively working to secure a markup in the House Energy and Commerce Committee with the goal of passing the bill in the 115th Congress.
VNAA is also working to build bipartisan support for newly introduced home healthcare and hospice legislation:
* The Home Health Documentation and Program Improvement Act (H.R. 2663), introduced by Representatives Kenny Marchant (R-TX) and Earl Blumenauer (D-OR), aims to fix the face-to-face documentation requirement for home healthcare services.
* The Patient Choice and Quality Care Act (H.R. 2797/S. 1334), introduced by Representatives Earl Blumenauer (D-OR) and Phi Roe (R-TN) and Senators Mark Warner (D-VA) and Johnny Isakson (R-GA), would improve the options for patients seeking advance care planning.
* The Preserve Access to Medicare Rural Home Health Services Act (S. 353), introduced by Senators Susan Collins (R-ME) and Maria Cantwell (D-WA), would extend the 3% rural add-on for Medicare home healthcare services. This payment modifier ensures rural agencies, which face higher overhead expenses, will be able to provide necessary care to homebound patients.
It is unclear how or when these bills will pass, but the Members of Congress supporting them deserve to be applauded for their commitment to crossing the aisle to preserve access to important home- and community-based healthcare services.