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In August 2009, NAHA member hospice Haven Hospice won its court challenge to the hospice cap regulation.  Federal Judge George Wu ruled the hospice cap regulation invalid, set aside CMS’ 2006 cap demand to Haven Hospice and ordered HHS to either return funds previously paid by Haven Hospice or apply those funds (including interest already paid) to a new demand.  Since then, more than ten other federal judges, in suits brought on behalf of individual hospices, have held the regulation invalid and precluded further application to those hospices.

But, the Haven Hospice and other decisions do nothing for other hospices that receive demand letters.  Hospices that receive repayment demands should appeal such demands (within 180 days).   By doing so, hospices may reduce their liability and recover prior interest payments to HHS.

For more information contact Brian Daucher at (714) 424-2843 or at bdaucher@sheppardmullin.com. Read More→

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Add your voice of support to NAHA Board’s letter to Secretary Sebelius requesting that she, and HHS, “Do the Right Thing:  Stop Using the Invalid Hospice Cap Regulation”.

How to send an email to Secretary Sebelius in a few simple steps:

First, adopt the right attitude… remember Secretary Sebelius did not draft the hospice cap regulation BUT she can decide to not use it now that it has been invalidated (twice).  So, be firm, direct, open, and very polite.  Any lack of civility in your email will, at a minimum, diminish its value and, potentially, damage the overall cause.

Second, compose your own letter in your own words.  “Cookie-cutter” or “cut and paste” letters will be much less effective than a sincerely worded, personal letter.  The following text template is provided for your reference as to what types of information you should include.  Please use the full closing information (name, address, and phone number).  You will not be contacted but it is important that your email communicate that you are a “real” person rather than some computer generated mailing campaign. Read More→

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Letter to Secretary Sebelius at HHS:  Do the Right Thing, Stop Using the Invalid Hospice Cap Regulation!

September 15, 2009

Kathleen Sebelius
Secretary, Health and Human Services

Dear Ms. Sebelius:

Re:  Hospice Cap Regulation

The National Alliance for Hospice Access (NAHA) represents more than 500 independent hospices in 32 states that serve tens of thousands of patients every year, primarily in rural, minority or economically disadvantaged communities.   As you know, NAHA is supporting hospice reform legislation (HR 3454) as well as hospice cap compromise efforts that would improve patient choice, reform the hospice cap, reduce HHS’ administrative burden, and reduce Medicare’s costs by $10 billion to $20 billion over the next ten years. We hope you will consider supporting these reforms…

Read the full text of the NAHA_Board_Letter_to_Sebelius_15Sep09

Read More→

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Federal Court Judge Puts Hold on His Own Nationwide Injunction; Will HHS Resume Use of Invalid Hospice Cap Regulation?

On August 20, 2009, Federal district court judge George Wu entered final judgment against the Department of Health and Human Services (read Final Federal Court Judgment Remand) in favor of NAHA member hospice Los Angeles Haven Hospice on its challenge to the hospice cap regulation.  In addition to provisions affecting only Haven Hospice, Judge Wu’s decision included a nationwide injunction precluding HHS from using the invalid regulation to calculate any future cap demands. Read More→

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Follow HR 3454 Medicare Hospice Reform and Savings Act of 2009, To amend title XVIII of the Social Security Act to reform payments and coverage for hospice care, on OpenCongress.org

H.R. 3454: Medicare Hospice Reform and Savings Act of 2009

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You can follow the progress of our newly introduced legislation, H.R. 3454 Medicare Hospice Reform and Savings Act of 2009,  To amend title XVIII of the Social Security Act to reform payments and coverage for hospice care, on GovTrack.US or on the NAHA site.

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NAHA Press Release:  August 26, 2009

Judge Tells HHS to Stop Using Invalid Hospice Cap Regulation

On Friday, August 21, 2009, Federal District Court Judge George Wu entered final judgment against the Department of Health and Human Services in favor of Los Angeles Haven Hospice on its challenge to Medicare’s hospice cap regulation.  Haven Hospice had challenged the regulation used to calculate the hospice cap on the grounds that it did not meet the clear requirements of the governing hospice cap statute. The decision demonstrates that HHS has been miscalculating the cap, and harming hospices, by failing to give proportional allowances that could decrease the cap liability of any hospice that has experienced periods of long average length of stay.

Read the full text of the NAHA Press Release

Read the Federal Court Judgment in favor of NAHA member Haven Hospice

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Judge Tells Department of Health and Human Services (HHS) To Stop Using Invalid Hospice Cap Regulation

On Friday, August 21, 2009, Federal district court judge George Wu entered final judgment against the Department of Health and Human Services (read Final Federal Court Judgment Remand) and in favor of NAHA member hospice Los Angeles Haven Hospice on its challenge to the hospice cap regulation. Read More→

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Aug
04

NAHA Endorses Hospice Reform Legislation

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NAHA Statement on the Medicare Hospice Reform and Savings Act of 2009

The National Alliance for Hospice Access (NAHA) endorsed legislation introduced today that reforms Medicare hospice regulations, improves patient access to hospice care, provides needed relief to hundreds of threatened hospices and saves the Medicare program as much as $2 billion a year. Read More→

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Jul
29

Update: Haven Hospice Cap Suit

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Yesterday (July 27, 2009), Judge Wu in the Federal court for the Central District  of California held a status conference to begin considering the proper form of judgment to follow his prior ruling July 13 holding the hospice cap regulation invalid.   Judge Wu considered some initial submissions by the parties, asked for further briefing, and reset the matter for August 6.  In the meantime, Haven Hospice’s FY 2006 repayment obligations remain suspended.  Haven Hospice is seeking a judgment that: (a) invalidates the current regulation; (b) sets it aside; (c) precludes the government from applying it to any hospice in future; and (d) sets aside the prior calculation for FY 2006 as to Haven Hospice.  Please note: Even if Haven Hospice gets all of the relief it seeks, this judgment will not preserve other hospice’s appeal rights as to cap demands that are issued prior to the entry of such judgment.  For this reason, it remains important for hospices that might benefit from a correct proportional allocation of cap allowances to seek counsel and timely file a PRRB appeal of any such demand.

For further information, read NAHA posts Federal Court Suspends Cap Demand and Federal Court Rules Cap Regulation Invalid (Again).

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Categories : Hospice Cap
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