Home Health & Hospice Week

Hospices are attacking the punishing wage index-based reimbursement cut from Medicare on multiple fronts.

The National Hospice & Palliative Care Organization has filed a lawsuit against the Cen-ters for Medicare & Medicaid Services to block the elimination of the Budget Neutrality Adjustment Factor (BNAF). The BNAF cuts finalized in July will strip 4.4 percent from hospices' Medicare payment rates over four years (see Eli's HCW, Vol. XVII, No. 28, p. 218).

The cut "would irreparably damage hospice programs across the country," NHPCO said in announcing the suit. The federal lawsuit seeks an injunction against the cut based on CMS' lack of analysis about the change.

"The Administration's rule is arbitrary and capricious," NHPCO's J. Donald Schumacher says in a release. "It will force many hospice providers across the country to either significantly scale back the care they provide to terminally ill patients or to shut their doors altogether."

The court will review the request within a few weeks, says the National Association for Home Care & Hospice, which assisted with the suit.

Meanwhile, the industry is also advocating for elimination of the cut in Congress. On Sept. 11, Reps. Chris Van Hollen (D-MD), Jim Ramstad (R-MN) and Maurice Hinchey (D-NY) introduced the Medicare Hospice Protection Act (H.R. 6873) that would block the cut for one year. Sens. Arlen Specter (R-PA), Tom Harkin (D-IA), Pat Roberts (R-KS), and Ron Wyden (D-OR) plan to introduce a companion bill in the Senate, NAHC reports.

As the population ages, "now is not the time to cut back on Medicare reimbursement for hospice services, which are cost effective and save Medicare money," the members of the House said in a "Dear Colleague" letter about the measure.

Attention paid: The mainstream press is picking up on the issue. "This is a terrible time to undercut one of the best parts of the health-care delivery system -- and one that is saving money anyway," Robert G. Wilson of the Hospice of the Comforter in Altamonte Springs, FL, tells the Orlando Sentinel. "Logic doesn't even seem to be the issue. It's politics."

The cut would cost Hospice of the Com-forter nearly $1 million in its first year, Wilson says.

CMS is discounting the industry's arguments. Hospices are distorting the impact of the changes, which are necessary because the number of hospices and their costs have skyrocketed in recent years, CMS spokesperson Jeff Nelligan tells the newspaper. The agency hasn't had a chance to respond to the lawsuit yet, he adds.

But hospices say they have grown to take up the slack for other providers, like hospitals, that don't care for dying patients like they used to, the Sentinel says.