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Dole Calls for Change in Medicare's 'Homebound' Rule

  • June 27th, 2002

June 27, 2002--A Medicare rule that requires beneficiaries to be "homebound" to receive home health care services is outmoded and should be amended, says former Senator Bob Dole in an opinion piece in the Washington Post.

One of the criteria for receiving home health services paid for by Medicare is that the recipient be confined to his or her home, meaning that leaving it to receive services would be a "considerable and taxing effort." The Medicare law also stipulates that absences from the home be of "infrequent and of short duration." Dole writes that the purpose of these restrictions was to deter abuse by limiting Medicare home health services to beneficiaries with severe illnesses or disabilities.

But the drafters of the legislation in the 1960s did not imagine the technological advances that now allow even the most severely disabled to leave their homes for work, volunteer activities and social interaction. Nevertheless, these same beneficiaries still require the services of home health care providers which, Dole says, 'provide a less costly alternative to nursing home or hospital care' for millions of Americans.

The rule, Dole contends, has turned nurses, doctors and home health administrators into watchdogs saddled with the responsibility to report any knowledge of their patients leaving their homes. Those receiving these services, Dole adds, 'must either lie or cheat just to enjoy fundamental liberties.' He tells of one woman whose home health care services were cut off after she attended the funeral for her child.

To "amend this harsh restriction on individual freedom," Dole urges the inclusion of the Homebound Clarification Act of 2001 (HR 1490) in the Medicare reform bill. The bill, also known as the David Jayne Amendment and drafted by Rep. Ed Markey (D-Mass.) and Sen. Susan Collins'' (R-Maine), would base the homebound determination solely on the existing standard of whether leaving home requires "considerable and taxing effort," eliminating the number or length of absences as criteria..

To read Sen. Dole's opinion piece, "Imprisoned by Medicare," click here

Read Rep. Markey's statement on the Homebound Clarification Act: http://www.house.gov/markey/iss_homebound_st010516.htm

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Last Modified: 06/27/2002

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