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March 06, 2008


Preserving Access to Hospice (PATH) Act

WASHINGTON, D.C. – U.S. Senator Jim Inhofe (R-Okla.) today introduced the Preserving Access to Hospice (PATH) Act (S.2727), legislation to ensure America's terminally ill seniors have access to hospice care.  The bill provides relief for hospice providers impacted by the Medicare hospice cap by placing a moratorium on the collection and calculation of hospice cap overpayments for fiscal years 2006, 2007 and 2008. This gives Congress, Medicare, and hospice providers the necessary time to develop and implement a long-term solution, while protecting patient access to hospice care. The bill also authorizes a Medicare Payment Advisory Commission (MedPAC) study to address the problem.
“I have been working since early 2007 to help small, community hospices in Oklahoma as they face repayment letters from the Centers for Medicare and Medicaid Services (CMS) for millions of dollars,” Senator Inhofe said. “Because of a flawed law, the federal government is requiring hospices to repay CMS for serving eligible patients in prior years.  Without a moratorium, these Oklahoma hospices, as well as hospices in numerous other states, will be unable to meet demands for repayment. As a result, many small family-and-community-owned hospices would be forced to close and discharge significant numbers of terminally ill patients, possibly into more expensive care.  
“My legislation provides immediate relief for impacted hospices by establishing a moratorium on the calculation and collection of hospice cap overpayments for 2006, 2007 and 2008, and authorizing a MedPAC study to determine the best way to address the hospice cap issue in the future.”

In 1982, Congress initiated the Medicare hospice benefit for terminally ill patients.  When a beneficiary elects hospice care, Medicare pays a flat fee per day for the care. A cap is placed on the number of days Medicare will pay for hospice care per patient.  The hospice is then responsible for all costs related to the care of this patient until their death, regardless of how long they remain in hospice care. 
In the 1980’s and 1990’s, Congress worked to broaden hospice coverage to ensure each eligible beneficiary had access to unlimited days of hospice care, regardless of their diagnosis.  While very few hospices initially reached the cap because of strict eligibility restrictions, hospices began drastically exceeding the cap as eligibility expanded.  In recent years, CMS has increasingly contacted hospices seeking repayment of millions of dollars used to care for these patients.  In 2005, 41% of the hospices providing care in Oklahoma received letters from CMS demanding repayment.

Senators Thad Cochran (R-Miss.), Roger Wicker (R-Miss.), Pete Domenici (R-N.M.) and Richard Shelby (R-Ala.) are co-sponsors of the Senate legislation.  Congressman John Sullivan (R-Okla.) today introduced companion legislation (H.R.5542) in the U.S. House of Representatives.  


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