[Congressional Record (Bound Edition), Volume 146 (2000), Part 12]
[Extensions of Remarks]
[Page 17218]
[From the U.S. Government Publishing Office, www.gpo.gov]



                  CLARIFYING THE HOMEBOUND DEFINITION

                                 ______
                                 

                         HON. EDWARD J. MARKEY

                            of massachusetts

                    in the house of representatives

                      Wednesday, September 6, 2000

  Mr. MARKEY. Mr. Speaker, on July 27 I along with 21 bipartisan 
Members introduced the Homebound Clarification Act of 2000, H.R. 5067 
the companion bill to the Senate bill sponsored by Senator James 
Jeffords (R-VT) and Senator Jack Reed (D-RI).
  This bill solves a problem in the current Medicare Home Health 
benefit that has created serious problems for Alzheimer's patients and 
our most frail, elderly and vulnerable Medicare beneficiaries.
  Under current law, in order for Medicare beneficiaries to receive 
coverage for home health services they must be ``confined to home''. 
Current policy interpretations by the Health Care Financing 
Administration and followed by fiscal intermediaries are causing 
substantial harm to Medicare beneficiaries by effectively forcing home 
health users to be unnecessarily restricted to their own homes.
  These restrictions impose harsh and irrational restrictions on 
patients and their caregivers. For instance, Alzheimer's patients are 
denied access to adult day services, which complement home health 
benefits, relieve caregiver burdens and delay nursing home placement, 
at no cost to the Medicare program. In another instance, home health 
services to a quadriplegic beneficiary who is lifted into a wheelchair 
and uses specially adapted transportation and is therefore not 
considered to be homebound.
  The introduction of the Homebound Clarification Act follows the 
introduction of similar legislation Representative Chris Smith and I 
introduced in March of 2000, H.R. 4028. This bill was a more narrowly 
crafted version of the Homebound Clarification Act bill and targets 
patients with Alzheimer's Disease and related dementia disorders only.
  The Homebound Clarification Act is endorsed by over 40 health and 
advocacy groups.
  This bipartisan legislation will help to improve the lives of 
millions of our most frail and vulnerable Americans. I look forward to 
continuing to work with my colleagues to pass this important measure.

                          ____________________