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'Homebound' modernization bill introduced
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Aug. 20, 2002 -- On August 1, 2002, Sen. Susan Collins (R-ME) introduced S. 2848, the David Jayne Medicare Homebound Modernization Act of 2002. The bill amends the Medicare home health statute that currently requires that an individual be "confined to the home" in order to receive in-home assistance. The bill currently has 5 co-sponsors: Sen. Max Cleland (D-GA), Sen. John F. Kerry (D-MA), Sen. Olympia J. Snowe (R-ME), Sen. Tim Hutchinson (R-AR), and Sen. Zell Miller (D-GA).

David Jayne's effort to update the Medicaid "homebound" regulation has been going on for nearly two years. Jayne first drew media attention in the fall of 2000 when a Thanksgiving Day weekend newspaper profile of the father with ALS, noting that Jayne left his home to give talks at his church and civic groups, alerted officials at Healthfield Home Health, who cut off his service, saying he violated Medicaid's "homebound rule." Jayne's case then got national coverage. Healthfield soon reinstated him, but the incident motivated him to start a national effort to abolish the rule. His website, at , contains information about the coalition that formed to accomplish this goal.

Medicaid policy currently considers a person "homebound" -- thus eligible for services -- only if absences from the house are "infrequent and of short duration." Senate bill 2848, says Jayne's website, would "provide an exception to the homebound rule to people who: 1) are certified by their physician to have a permanent and severe disability that is expected to persist for at least a year; 2) need the assistance of home health services to leave the home, and 3) are already currently eligible for home health services."

The Sen. Finance Committee has already drafted its version of the Medicaid Provider bill, and, Jayne says, "I have heard (from conversations with Finance staff) that the homebound language included in this bill is much more conservative than what's in S. 2848." Jayne is calling for a "strong grassroots effort so that Senator Daschle and Finance Committee Senators are motivated to make sure that the Finance bill includes S. 2848 in its bill (rather than what's currently included in the bill)." More information on how to be involved with this effort is at the website at

In late July, the federal Centers for Medicare & Medicaid Services agency clarified that people "should not lose home health services because they leave their homes infrequently for short periods of time for special occasions, such as family reunions, graduations or funerals." The "clarification" was announced by Pres. Bush as part of his ADA Anniversary speech, but, in a press release issued a few days later, Democratic National Committee Chairman Terry McAuliffe chastised Bush for calling for only a "little freedom" for people like Jayne to "occasionally take part in their communities without fear of losing their benefits." Approximately 46,000 Medicaid beneficiaries are estimated to fall under the "homebound" rule, say the Democrats.

Jayne says that CMS administrator Tom Scully has asked for "help in identifying Medicare beneficiaries who have had their home health services cut off because of an extremely harsh interpretation of the homebound restriction." Jayne asks that those knowing of such situations contact him at

Read more about S2848 at -- follow the progress of S 2848 at

Previous E-Letters have covered David Jayne's efforts:

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