Save Our Hospices From Devastating CMS Cuts!

On April 28, 2008, The Centers for Medicare and Medicaid Services (CMS) acted on a provision in the Administration’s FY09 budget proposal that would cut hospice reimbursement rates by altering the wage index adjustment (phasing out the budget neutrality factor). CMS has stated publicly that the final rule on this provision is expected on August 1, 2008.

While this may seem like a regulatory adjustment that would make minor changes to hospices wage formula, the regulation would take more than $2.3 billion from a health care sector that has 3.4% margins, according to a recent MedPAC study. Once fully implemented, this regulation would cut reimbursement in some areas by more than 18%. Make no mistake, these cuts will force programs to decrease services or close their doors completely. For example, in Texas, hospice programs will be especially hard hit. In Houston/Harris County, full implementation will bring rate reductions of 6.89%. Dallas/Dallas County programs will see losses of 7.74%. More rural areas, such as Lampasas County and McLennan County, will see cuts of 13.11% and 7.5%, respectively.

Hospice programs all across America served more than 1.3 million patients and families last year, in the place they call their homes, and that number is expected to continue to rise as more terminally ill patients seek high quality, compassionate end-of-life care. Additionally, research shows that hospice is cost effective. An independent Duke University study in 2007 showed that patients receiving hospice care cost the Medicare program about $2,300 less than those that did not. This amounts to more than $2 billion of savings each year.

Each day, thousands of people enter hospice programs, along with their families. This signifies their decision to spend their last days, weeks or months in the place they call home, relatively free of pain and intrusive medical interventions. They are surrounded by their families, friends and spiritual counselors. They die with the comfort of knowing that the grief and bereavement needs of their loved ones will be taken care of once they are gone. This is a choice that is free of political, racial or gender limitations. More than 80% of Americans making this choice each year are Medicare beneficiaries and their families are counting on this service to remain intact for future generations. Interestingly, more than 98% of these families would recommend hospice for another loved one.

On behalf of the millions of Americans who benefit each year from compassionate end-of-life care and bereavement services, I respectfully ask that you to halt further action on this regulation. I sincerely hope that you will stand with me in supporting continued access for all Americans to hospice care.

From National Hospice and Palliative Care Organization (http://www.nhpco.org/)

Please contact our representatives to urge them to save our Hospice programs at http://www.grizrph.com/repcontact.htm. You are welcome to use this letter that the National Hospice and Palliative Care Organization has provided for us to send.

Thank you!

We're Saved! Presidents veto of HR 6331 has been overridden by Congress!

On July 15th, Congress overrode the President's veto of HR 6331, the "MEDICARE IMPROVEMENTS FOR PATIENTS AND PROVIDERS ACT OF 2008". This bill had seen a lot of action in just a short period of time since it was introduced into the House on June 20th, 2008 and redrafted 4 times in which to pass both Senate and House by July 10th only to have the President veto the bill on July 15th. Later that day, both the House and the Senate overrode the veto with 2/3rd majority. This was a major victory for pharmacy!

With this bill as law, Physicians will actually get a 0.5% increase rather than a 10.6% decrease in reimbursement that was retroactive back to July 1, 2008.

For Pharmacy:

1. Requiring a 14-day reimbursement cycle for electronic Medicare Part D claims. Unfortunately this provision of the bill doesn't go into effect until 1/1/2010.

2. A further delay to Oct. 1, 2009 in instituting AMP-based Medicaid generic drug reimbursement cuts.

3. Postponement of the Medicare DME competitive bidding program for 18 to 24 months. CMS has clarified this as a postponement on implementation of Competitive Bidding Round 1, and a cancellation of accreditation deadlines for Competitive Bidding Round 2. CMS also clarifies that the deadline of September 30, 2009 that was previously established by which ALL DMEPOS suppliers must be accredited is still in effect.

The DME Competitive Bidding areas for Round 1 now are NOT subject to implementation: (1) Charlotte-Gastonia-Concord, NC-SC, (2) Cincinnati-Middletown, OH-KY-IN, (3) Cleveland-Elyria-Mentor, OH, (4) Dallas-Fort Worth-Arlington, TX, (5) Kansas City, MO-KS, (6) Miami-Fort Lauderdale-Miami Beach, FL, (7) Orlando-Kissimmee, FL, (8) Pittsburgh, PA, (9) Riverside-San Bernardino-Ontario, CA, and (10) San Juan, PR.

The votes were 383-41 in the House and 70 to 26 in the Senate, meeting the constitutional requirement for two-thirds margins to enact legislation without the president's signature. "The passage of this bill will guarantee community pharmacies the ability to help millions of patients and to compete on a level playing field," said Bruce T. Roberts, RPh, NCPA executive vice president and CEO.

Please thank your Representatives.all of them were for passage of HR 6331 and they got the job done.this wasn't any easy task! Use this link for their contact information: www.grizrph.com/repcontact.htm

HR 6331 passed Senate today and goes to President for Signature

With pressure on Senators from the American Medical Association as well as TRICARE and the re-election status for Senators, the Senate passed HR 6331, legislation that includes a 14-day reimbursement cycle for Medicare Part D claims, a further delay in AMP-based Medicaid generic drug reimbursement cuts, and suspension of the Medicare DME competitive bidding program. The cloture vote was 69 to 30. Sixty votes were required to move to final passage of the measure, whose main focus has been on preventing a 10.6% cut Medicare payments to physicians. Two previous attempts failed in the Senate last month. The House passed the bill with a cloture vote of 355-59 on June 24th. This bill will very shortly move to the President’s desk for signature.

Senate Democrats reminded members every chance they could that Medicare physician payment cuts will not just jeopardize seniors health care, but that of the nations troops and veterans. Military Officers Association of America on Tuesday sent 14,000 emails to their senators reminding them off this, since TRICARE rates are linked to Medicare rates by law.
Please send Senator Baucus a sincere thank you for all the hard work he has done to preserve the future of pharmacy and a thank you to Senator Tester as well for his strong support of pharmacy by supporting all our bills and vote for HR 6331.

In addition, if you hadn’t sent a thank you to Congressman Rehberg on voting for HR 6331, please do so. Representative contact information on http://www.grizrph.com/.