Congress: Support bipartisan legislative solutions during National Hospice and Palliative Care Month
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I recently had the privilege of testifying before the House Ways and Means Committee to discuss the value of hospice and palliative care in caring for aging Americans. During the hearing, I shared my Great Aunt Ruby’s story. Ruby is a former Pentagon staffer living on her own with end-stage Chronic Obstructive Pulmonary Disease (COPD) – a condition for which there is no cure. Managing her illness requires a significant amount of support, care, time and energy. It is simply too much for Ruby to handle on her own, and when complications arise, she often ends up calling 911 and being taken by ambulance to the emergency room.

Although COPD is a terminal illness, Ruby does not consider herself to be terminally ill and therefore does not believe that she is ready for hospice. With hospice, she would have access to person-centered, integrated care to better manage her disease and prevent costly hospitalizations. In addition to pain management, she would receive social, emotional and spiritual support, which would help my great aunt and our family come to terms with her illness. Without hospice, she is depressed and declining and has access to none of these unique benefits.

Unfortunately, like Aunt Ruby, too many aging and seriously ill Americans face barriers that limit access and choice when it comes to their health care. Improving care will require many reforms, and fortunately, there are solutions on the table that would be a step in the direction of strengthening hospice and palliative care in America.


First, Congress must advance the bipartisan Rural Access to Hospice Act (S. 1190/H.R. 2594), which will allow providers working in Rural Health Centers (RHC) and Federal Qualified Health Centers (FQHC) to receive payment for hospice services while acting as attending physicians for their patients. Under the legislation, RHCs and FQHCs would be able to bill and be paid for hospice attending physician services the same way they are currently paid for providing other services. Passing this bill will ensure individuals and families living in rural and underserved areas can select hospice without jeopardizing their relationship with their trusted physician.

Second, the Senate should pass the Palliative Care and Hospice Education and Training Act (PCHETA). This legislation would improve and expand professional training to meet the growing demand for hospice and palliative care. Already passed in the House with strong, bipartisan support, it is time for the Senate to act quickly to pass this bill and send it to President TrumpDonald John TrumpCNN's Don Lemon explains handling of segment after Trump criticism NPR reporter after Pompeo clash: Journalists don't interview government officials to score 'political points' Lawyer says Parnas can't attend Senate trial due to ankle bracelet MORE’s desk for his signature.

Without the support and resources this legislation provides, recent projections suggest that by 2030, there will only be one palliative care physician for every 26,000 seriously ill patients. Based on the influx of seniors entering the Medicare program daily, our senior care system cannot withstand such a shortfall of health care professionals. Therefore, Congress should finish the job and pass PCHETA this year.

At the same time, Congress should work with stakeholders to ensure better hospice care and smart oversight of that care. As I announced at last week’s hearing, we have been working with leaders in both Congress and the administration to develop policies that would implement safeguards, improve education and enhance information available to consumers, all of which would support the hospice provider community in offering patients and families the highest quality hospice care possible. To that end, we support the policies that enhance smart oversight in the Hospice Care Improvement Act of 2019 (S. 2807). This bipartisan legislation implements new safeguards and strengthens existing ones in order to protect patients facing serious illness at the end of life.

At the hearing, many committee members shared their own family members’ stories of struggling with serious illness and benefiting greatly from hospice care. The Medicare Hospice Benefit has so much to offer to patients and families, but more must be done to reach and support them. It is important for the government and other key stakeholders to work together to put policies in place that ensure adequate access to highly trained health professionals, remove unnecessary barriers to care, and advance reforms to improve program integrity.


In addition to the evolutionary but meaningful reforms we have mentioned, it will also be necessary to fundamentally question some of the outdated requirements that restrict access to much-needed care. Why? Because my Great Aunt Ruby’s story is not unique. Why do people have to be dying in order to get person-centered, interdisciplinary care? Why don’t we have a community-based palliative care benefit in Medicare? These are all questions that we will seek to work on and answer with our partners.

As we celebrate National Hospice and Palliative Care Month, I applaud the Ways and Means Committee for shining a light on the issues impacting aging Americans and other leaders in Congress who have recognized the critical role hospice care plays in our health care system, have championed hospice issues and are working with the provider community to advance these important legislative solutions. By working with stakeholders to strengthen the Medicare Hospice Benefit, Congress can do what is best for all Americans.

Edo Banach, JD is President & CEO of the National Hospice and Palliative Care Organization.