Public Policy

HPCANYS has a strong advocacy program to promote policy, legislation, and regulation that support the Association's mission to promote the availability of quality hospice and palliative care for all persons in New York State contronted with life-limiting illness. HPCANYS' State Legislative/Regulatory Commitee and Federal Legislative/Regulatory Committee provide support for the Association's advocacy activities.

HPCANYS Position Statements and Comments

 FY 2021 Hospice Wage Index and Payment Rate Update 

In April, CMS published the update and we have been working with the QAPI and the Clinical Leadership Peer Groups to formulate our comments.  They were submitted on June 8th.  We thanked CMS for the 2.6% increase in all levels of care.  But we objected to initiating the Addendum and Updated Benefit Election Form at this time.  We pointed out that the EMR vendors, as of March, have not released their upgrades that would allow us to electronically document and produce the Addendum.  With the pandemic hitting New York so hard, no provider in impacted areas will have the time or staff availability to implement them before the 10/1/2020 deadline.  We requested that this be delayed until a year after the Public Health Emergency has been canceled and we cited an example of a home care regulation that was delayed for that reason.  
Further, we commented on many aspects of the sample addendum and election statement for when they will need to be used.  CMS did not include statutory language in the sample election statement saying  hospice should cover all care related to my terminal illness and related conditions needed under the hospice election.  We corrected that, citing Medicare regulations, to I also understand that services unrelated to my terminal illness and related conditions are exceptional and unusual and hospice should cover virtually all care related to my terminal illness and related conditions needed under the hospice election that are reasonable and necessary for the palliation and management of the terminal illness as well as related conditions and as consistent with and delineated in a specific patient plan of care.  
We suggested deleting the witness requirement which is not statutorily required, putting the name of the hospice on the form, increasing the font, and a few other items to help it read more easily. 
Although we have some faith that this can be moved, hospices will have to continue to work on the implementation until CMS responds.  They generally respond by end of July or early August to the comments.  
 Carla was on the workgroup at NHPCO for their response as well.  Although not identical, we did not disagree with each other in the responses.  HPCANYS was more specific to NY State's experience during the pandemic.

Support the Rural Access to Hospice Act (S. 980/H.R. 1828).

When patients enroll in hospice, they select a physician or nurse practitioner to serve as their attending physician. The attending physician collaborates with the hospice in the development of the care plan, and is kept informed of the patient's care. Attending physicians are typically reimbursed for their services under Medicare Part B. However, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are not reimbursed under Part B. As a result, these clinics, which serve over 27 million Americans in under-resourced and rural communities, cannot provide or be reimbursed for hospice attending physician services.

The Rural Access to Hospice Act, led by Congresswoman Lynn Jenkins (R-KS) and Congressman Ron Kind (D-WI) in the House and by Senators Shelley Moore Capito (R-WV) and Jeanne Shaheen (D-NH) in the Senate, addresses this issue by allowing RHCs and FQHCs to receive payment from hospice attending physician services.

Support the Palliative Care and Hospice Education and Training Act (S. 693/H.R. 1676).

Research from the American Academy of Hospice and Palliative Medicine (AAHPM) indicates that there is a shortage of adequately trained hospice or palliative care providers. Moreover, the current rates of educating and training medical professionals in palliative care will not be sufficient to ensure that aging Americans will have access to quality palliative care.

The Palliative Care and Hospice Education and Training Act (PCHETA) establishes a variety of palliative care and hospice training programs that would increase the number of healthcare professionals trained in these techniques. The legislation also supports a national education campaign to increase awareness about palliative care, and supports research to improve delivery of palliative care.

In the house, PCHETA is sponsored by Congressmen Eliot Engel (D, NY-16), Tom Reed (R, NY-23) and Buddy Carter (R, GA-1). In the Senate, PCHETA is sponsored by Senators Shelley Moore Capito (R-WV) and Tammy Baldwin (D-WI).

Support the Patient Choice and Quality Care Act of 2017 (S. 1334/H.R. 2729).

Americans with serious and advanced illness often receive fragmented, uncoordinated care that increases their risk
for repeat hospitalizations, adverse drug reactions, unnecessary emergency room visits, and unwanted, ineffective
care. Too often, individuals with advanced illness do not understand the conditions they face or their treatment
options. Additionally, they often do not receive the information or support they need to evaluate treatment options
in light of their personal values goals of care, or to document treatment plans in a manner that allows providers and
facilities to follow the patients treatment plans.

The Patient Choice and Quality Care Act will give these patients and their families access to the kind of information
and services they need. This bipartisan legislation directs the Center for Medicare and Medicaid Innovation to conduct an Advanced Illness Coordination Services demonstration, which will allow an interdisciplinary team to provide early palliative care and wrap-around, home-based services to individuals with multiple and complex chronic conditions. The Patient Choice & Quality Care Act is sponsored by Congressmen Earl Blumenauer (D-OR) and Phil Roe (R-TN) in the House, and by Senators Mark Warner (D-VA) and Johnny Isakson (R-GA).

Contact Your Representatives

Legislative contacts are divided into two categories, state and national levels. Each of the following links will take you to a site where you can put in some information about your location (like your zip code) and find out who represents you in government.

New York State Legislative Contacts New York State Assembly. Click on link and enter your address, city and zip code in the form on the page. You will then be provided a link to your representatives website, where you will find email and telephone contact information. New York State Senate Click on the link and enter your address and zip code under Find my Senator. Your representatives name will appear at the top of the page, and you can write an email directly from this page with the form provided.

National/Federal Legislative Contacts United States House of Representatives: Click on the link and search for your representative by entering your zip code. Your representatives name will appear at the top of the page, and you can write an email by clicking on the envelope icon. New York State Senators: This page lists the email and telephone contact information for Chuck Schumer and Kristen Gillibrand, the two Senators who represent residents in New York State.