Key Hospice Priorities Included in Year-End Legislation

Categories: In The Media and Policy.

NHPCO Applauds Inclusion of Rural Access to Hospice Act

Just before midnight on Monday, December 21, the Consolidated Appropriations Act, 2021 (H.R. 133) passed both chambers of Congress and the President is expected to sign. The legislation combined an omnibus spending bill, COVID-related provisions, and included hospice provisions. The National Hospice and Palliative Care Organization (NHPCO) applauds inclusion of provisions to support hospice care in the U.S.

“NHPCO appreciates this bi-partisan, bi-cameral agreement. Hospice patients and families will benefit from improved access in rural and underserved communities as well as needed relief during this public health emergency. This legislation will enable hospice providers to continue providing uninterrupted care during this unprecedented time,” said NHPCO President and CEO Edo Banach.

There are several hospice related provisions included in the package:

  • Rural Access to Hospice Act (S. 1190/H.R. 2594). Beginning on January 1, 2022, Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) can receive payment for hospice services furnished while serving as attending physicians for their patients under Medicare Part B. Some of the most underserved beneficiaries across the nation will soon have the choice they deserve at the end of life to remain under the care of the RHC or FQHC provider they have known and trusted, in some cases for decades, while in hospice. NHPCO led efforts to include the Rural Access to Hospice Act, introduced by Senator Capito (R-WV) and Senator Shaheen (D-NH) and Congressman Kind (D-WI-3) and Congresswoman Walorski (R-IN-2) in H.R. 133.
  • Helping Our Senior Populations in Comfort Environments (HOSPICE) Act (H.R. 5821). This hospice program integrity legislation, introduced by Congressman Jimmy Panetta (D-CA-20) and Congressman Tom Reed (R-NY-23), was originally drafted in response to the July 2019 HHS Office of Inspector General report findings on quality in hospice care. The HOSPICE Act incorporates NHPCO recommendations for improving the survey process by including increased surveyor training and competency that will improve the overall survey process. It creates a new Special Focus Facility Program for poor-performing hospices, who will be surveyed not less frequently than once every six months.  The bill also increases the penalty for hospices not reporting quality data to the Secretary of HHS from two to four percentage points, beginning in FY 2024 and allows the Secretary to use intermediate remedies to enforce compliance with hospice requirements, including civil monetary penalties. NHPCO was successful in reducing the survey frequency of every two years included in the House bill to every three years in the final package.
  • Sequestration Relief. The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) was signed into law on March 27, 2020 and included a suspension of the 2% sequestration reduction for most Medicare payments. Section 4408 of the CARES Act exempts Medicare from the effects of sequestration from May 1, 2020, through December 31, 2020.  The Consolidated Appropriations Act of 2021 (H.R. 133) extends this relief through March 31, 2021. This will enable providers to keep their doors open and offer care to communities in need as COVID-19 infections continue to rise. NHPCO led a coalition of providers in requesting this critical extension of relief.

Additional provisions that will impact the hospice community include the extension from 2025 to 2030 of the IMPACT Act of 2014’s provision to calculate the aggregate hospice cap amount based on the hospice payment update, modifications to and additional funding for the Paycheck Protection Program, and $3 billion in additional Provider Relief Funding.

“We have led the efforts of the hospice provider community to tear down barriers to person-centered interdisciplinary care in rural and medically underserved communities for years and truly appreciate the leadership of Senator Capito (R-WV), Senator Shaheen (D-NH), Congressman Kind (D-WI), and Congresswoman Walorski (R-IN) in improving support for rural health care by introducing the Rural Access to Hospice Act,” said Banach.

Added Banach, “NHPCO supports smart oversight when it does not hinder access to high quality care for patients and their families. Hospice providers that are following the rules should not be subjected to excessive administrative burden and forced to needlessly divert resources from patient care.  We look forward to working with HHS on implementation to ensure that new program integrity standards will not adversely impact access to hospice care.”

NHPCO members can expect a Policy Alert with more detailed information about the package to be released later today.

To stay up to date with the latest in hospice and palliative care legislative news, visit the Hospice Action Network’s Legislative Action Center.


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