Also present was David Jayne, the founder of the National Coalition to Amend the Medicare Homebound Restriction, and the man for whom the amendment is named. Mr. Jayne is living with ALS, an always fatal, debilitating disease that requires him to receive home health care visits. Despite his disability, he has worked tirelessly to promote awareness among members of Congress for the need to modernize this provision of Medicare.
"This critically important amendment will modernize Medicare's outdated homebound restriction so that courageous individuals like David Jayne, who live with permanent and severe disabilities, can leave their homes to join their families in activities and participate in their communities without losing their life-sustaining home health services," said Senator Collins.
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 benefits, his or her condition must be such that "there exists a normal inability to leave home."
The statute does allow for absences from the home that are "infrequent and of short duration." It also gives specific permission for the individual to leave home to attend medical appointments, adult day care or religious services. Otherwise, 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 recipients – who are dependent upon Medicare home health services and medical equipment for survival – into virtual prisoners in their own homes,"the Senator said.
The current homebound requirement is particularly hard on younger, disabled individuals who are on Medicare. "The fact is that the current requirement reflects an outmoded view of life for persons who live with serious disabilities. The homebound criteria may have made sense thirty years ago, when an elderly or disabled person might expect to live in the confines of their home – perhaps cared for by an extended family. The current definition, however, fails to reflect the technological and medical advances that have been made in supporting individuals with significant disabilities and mobility challenges."
Also attending today's news conference were representatives of the Visiting Nurse Associations of America, a long-time and active proponent of modernizing the Medicare homebound restriction.
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