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Congressional Quarterly Today reports that the “hospice industry is preparing a lobbying effort aimed at persuading lawmakers to delay a new regulation that would cut Medicare reimbursement for palliative, end-of-life care. The article cites Jon Keyserling, NHPCO vice president for public policy and counsel, as saying that the Bush administration had tried for two years to get Congress to reduce Medicare hospice payments, but with no success. It then issued the rule this summer. Keyserling said, “Here you have a health care delivery system targeted for the most vulnerable population in our country that is cost effective; it’s widely regarded as extremely high quality…it’s growing, and gaining wider acceptance. Why CMS or the administration would step in and try to cut back on beneficiary access to such a program is just bewildering to me.

The author of the article says, however, that “hospices might have missed their best chance to win a delay of the regulation. In mid-July, both houses of Congress overrode “a Bush veto of legislation (PL 110-275) that averted a scheduled cut in Medicare reimbursement to physicians and also blocked several Medicaid regulations the administration was planning. Observers think it unlikely that Congress will consider another “significant health care bill this year, so the best hope for averting the cuts may be “attaching a delay of the rule to a continuing resolution that is expected to be passed this fall to keep the government running into 2009. (Congressional Quarterly Today, 8/6;

Ogeechee Area Hospice has, historically, been able to offer care that is beyond the regulatory guidelines of Medicare. This, in most part, has been due to the support of our community through charitable contributions. Medicare and other health insurance reimbursement has remained at a margin of +2% to -2%, compared to expenses, from year to year. This narrow margin is in line with national data on non-profit hospice providers, indicating again, that high quality service is our mission.

Newsday columnist Saul Friedman says, “I have a serious problem with those studies and stories that suggest Medicare is spending too much money caring for beneficiaries in their last two years of life. The questions beg to be asked: How much is too much? Who wants to save money on the dying? And what’s the alternative?

We need to continue to ask the same question of Chambliss, Isakson and our representatives of Congress.