David Jayne,
NCAHB Founder
Submitted to bridges4kids by Brunhilde Merk-Adam.
Dear friends of NCAHB,
I am very pleased to inform
you that President Bush announced today
during the ADA anniversary ceremony,
a clarification of Medicare policy to
ensure that people with severe disabilities
considered "homebound" under
Medicare home health requirements are
able to leave their homes occasionally
without the risk of losing their Medicare
coverage. This is a good start, but we still
need a legislative remedy.
While in Washington I met
with Tom Scully, the Administrator of the
Center on Medicare and Medicaid
Services, which is the federal agency
responsible for overseeing the Medicare home
health benefit. Mr. Scully said that
he is extremely concerned that some
Medicare beneficiaries are unjustly and
wrongfully thrown off the home health
benefit for so called homebound violations.
He said he has personally
restored home health services to those who
lost theirs due to an overly restrictive interpretation of the
homebound rule.
The CMS Administrator also
asked for NCAHB's
help in identifying Medicare beneficiaries
who have had their home health services cut
off because of an extremely harsh
interpretation of the homebound restriction.
If you or someone you know have been cut off home health
for what you believe to have been a
wrongful interpretation of the homebound
rule, I urge you to contact me
djayne23@aol.com
Describe the circumstances
surrounding why home health services were
discontinued because of an alleged homebound
violation. Explain your disability or
chronic illness and why you need to continue
to get Medicare
home health services. Include contact
information (e mail, phone and mailing address) for
yourself and the home health agency so that Mr. Scully's
staff can follow up.
Below is a press release
from CMS on today's events.
FOR IMMEDIATE RELEASE
Contact: CMS Public Affairs
Friday, July 26, 2002
(202) 690-6145
MEDICARE ACTS TO PROTECT
COVERAGE FOR HOMEBOUND BENEFICIARIES
The Medicare program today
took action that will provide reassurance to
chronically disabled homebound Medicare
beneficiaries that they can continue to
receive home health care even if they leave their homes for
special non-medical purposes.
In new instructions, HHS
Centers for Medicare & Medicaid Services
(CMS) directed home health agencies
and the contractors that pay home health
claims to be more flexible in determining if a severely
disabled individual is qualified as
homebound.
The instructions make clear
that chronically disabled individuals who
otherwise qualify as homebound should not
lose home health services because they leave
their homes infrequently for short periods of time for
special occasions, such as family reunions, graduations or
funerals. In some instances, home health
agencies and Medicare payment contractors
have terminated home health benefits
after a beneficiary attended a special
event, even though the beneficiary otherwise continued to
qualify as homebound.
"We want to make sure that
every person who is covered by Medicare is
treated fairly and sensibly," HHS Secretary
Tommy G. Thompson said. "These
new instructions will help guarantee that chronically disabled
Americans who need Medicare's home
health benefits will not lose their coverage
if they leave their homes
for special family occasions."
The new language in the
program manual for home health agencies:
Expands the list of
examples used to illustrate occasional absences from
the home and notes that the list is
still not all inclusive; Adds the late
stages of amyotrophic lateral sclerosis (ALS or Lou
Gerhig's disease) or
other neurodegenerative disabilities to the
list of
examples of conditions that may indicate that the patient
cannot leave his
or her home; and Makes it clear that
the determination as to whether a person is
homebound is one that must be made over a
period of time, not on a daily or weekly
basis, so a few special trips outside the
home would not be used to disqualify a
patient who has a normal inability to leave the home.
"While Congress weighs the homebound
definition in current law, we have the
responsibility to make sure that chronically
disabled people who are considered to be
homebound can live a full life," CMS
Administrator Tom Scully said. "By adding
these examples, we make it clear that disabled
Medicare beneficiaries can take
advantage of an opportunity to go to their
child's wedding or other special
family occasion without the fear of
losing vital benefits."
Under current law, to
qualify as homebound, a Medicare beneficiary does
not need to be bedridden, but must
generally be confined to his or her home. If
the patient does leave the home for non-medical
purposes, these absences must be for
short periods of time or infrequently. In 2000,
Congress expanded the homebound
definition to allow patients to attend adult
day care programs or religious services.
Medicare's
$13 billion home health benefit provides short-term
health and personal care services to
beneficiaries who have a need for home
health services and qualify as homebound. An estimated 2.5
million Medicare beneficiaries will receive
home health services this year.
Note: All HHS press
releases, fact sheets and other press materials are
available at www.hhs.gov/news.
Honoring the Anniversary
of the Americans with Disabilities Act
Today's Presidential
Action: In an East Room ceremony marking the 12th
anniversary of the enactment of the
Americans with Disabilities Act, President
George W. Bush: Announced a clarification of Medicare policy
to ensure that people with severe
disabilities considered "homebound" under
Medicare home health requirements are able
to leave their homes occasionally without
the risk of losing their Medicare coverage;
and Called on Congress to fund his New
Freedom Initiative budget requests,
including $145 million for: (1) competitive
grants to provide additional transportation
services for Americans with disabilities, increasing
their access to the job market; and
(2) a pilot program to demonstrate
innovative solutions for transportation
problems that prevent many people with
disabilities from living more independently. President
Bush also praised the work of the
Commission on Excellence in Special Education,
which recently recommended
improvements in the education of students with
disabilities to Congress and the President.
These recommendations will help
Congress as it considers the reauthorization of the Individuals with
Disabilities Education Act (IDEA). President Bush has made
funding for special education a high
priority. In each of the President's two
budget requests, he has asked Congress for
an additional $1 billion in IDEA Part B
State Grants funding, the largest increases ever requested in history
by any president. Background on
Today's Presidential Action: On February 1,
2001, President Bush announced the New Freedom Initiative - a
comprehensive program to promote the full participation of
people with disabilities in all areas of
society by increasing access to assistive
and universally designed
technologies, expanding educational and employment
opportunities, and promoting increased access into daily
community life. The Administration is
committed to the full enforcement of the
Americans with Disabilities Act. The ADA
prohibits discrimination on the basis of
disability in:
Places of public
accommodation, including all hotels, restaurants, retail
stores, theaters, health care
facilities, convention centers, parks, and
places of recreation; Activities of state
and local governments, including public
transportation and employment; and
Employment practices of
private employers with 15 or more employees. The
New Freedom Initiative also increases
technical assistance to help small
businesses comply with the ADA. The President believes that the
most efficient way to promote
compliance with the Act is to give businesses
and local governments the
information they need to better understand their
obligations. Examples of the Administration's innovative
efforts to promote compliance with
the ADA include the Department of Justice's "ADA
Business Connection," which is
increasing compliance by fostering an ADA
dialogue within the business community and increasing
the flow of ADA information to
business decision makers. Additionally, the Equal
Employment Opportunity Commission is
providing ADA training to small businesses
throughout the country. For a full progress report
on the implementation of the New
Freedom Initiative, please visit
http://www.whitehouse.gov/infocus/newfreedom/.
For more information on the
President's initiatives, please visit
www.whitehouse.gov.
Best regards,
David Jayne
NCAHB Founder
http://www.amendhomeboundpolicy.homestead.com
115 Hayes Circle
Rex, Georgia 30273
djayne23@aol.com
