WASHINGTON, D.C. - Senator Susan Collins is continuing her fight to amend the "homebound" classification in the current law governing Medicare eligibility requirements, by introducing legislation to bring the law in line with advances in medical care. Under current law, a Medicare patient must be considered "homebound" if he or she is to be eligible for home health services. While an individual is not actually required to be bedridden to qualify for the benefit, his or her condition must be such that "there exists a normal inability to leave home," and leaving home must require "a considerable and taxing effort by the individual." The statute does allow for absences from the home of "infrequent" or "relatively short duration." Unfortunately, however, it does not define precisely what this means. It leaves it to the fiscal intermediaries to interpret just how many absences qualify as "frequent" and just how short those absences must be. Interpretations of this definition have therefore varied widely. "As a consequence, there have been far too many instances where an overzealous or arbitrary interpretation of the definition has turned elderly or disabled Medicare beneficiaries - who are dependent upon Medicare home health services and medical equipment for survival - into virtual prisoners in their own home," said Senator Collins.
"Current regulations fail to recognize that an individual's mental acuity and physical stamina can only be maintained by use, and that the use of the body and mind is encouraged by social interaction outside the four walls of a home. My legislation that will update the ‘homebound' definition to base eligibility for the home health benefit on the patient's functional limitations and clinical condition, rather than on an arbitrary limitation on absences from the home.
Senator Collins's bill, The David Jayne Medicare Homebound Modernization Act, is supported by the supported by the Consortium of Citizens with Disabilities, the Visiting Nurse Associations of America, the National Association for Home Care, Advancing Independence: Modernizing Medicare and Medicaid (AIMM), the National Coalition to Amend the Medicare Homebound Restriction, the Paralyzed Veterans of America, and the Half the Planet Foundation.
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