United States senators Jacky Rosen (D-NV), John Barrasso (R-WY), Tammy Baldwin (D-WI), and Deb Fischer (R-NE) sponsored a bill that would direct the Center for Medicare and Medicaid Innovation (CMMI) to develop a palliative care-specific payment model demonstration.

The four legislators co-founded the Senate’s bipartisan Comprehensive Care Caucus for the introduction of the bipartisan Expanding Access to Palliative Care Act (S.1845), which proposes the creation of a demonstration project to support improved access to palliative care services. If the bill passes, it would require the Center for Medicare and Medicaid Innovation (CMMI) to develop a community-based palliative care demonstration. The program would provide essential care to people with serious illnesses in their homes, which could lead to improved quality and cost outcomes.

One of the Bill’s Priorities

Among the bill’s priorities is ensuring that patients can access palliative care services earlier. Senator Rosen states, “Palliative care has been shown to improve health outcomes and quality of life, but unfortunately, for seniors, it is only currently available to patients in hospice.” Senator Rosen goes on to say, “That’s why I’m introducing bipartisan legislation to expand Medicare coverage of palliative care, making it available to seniors earlier in the diagnosis and treatment process.”

Who Pays for Palliative Care?

Palliative care is currently not covered by Medicare. Oftentimes, palliative care is covered under a fee-for-service arrangement, for example, under Medicare Parts A and B. Original Medicare may cover may cover palliative care under certain conditions, such as for beneficiaries who have a terminal illness. In order for Medicare to cover palliative care, the patient must qualify for hospice coverage under Medicare Part A by meeting the following conditions:

• The hospice doctor and regular doctor each certify that the person is terminally ill with life expectancy of six months or less.
• The patient must sign a statement choosing hospice care instead of other Medicare-covered benefits to treat the illness.
• The patient must accept palliative care for comfort instead of care designed to cure the illness.

What is The Comprehensive Care Caucus?

The purpose of the Comprehensive Care Caucus is to raise the public’s awareness and promote the availability and benefits of palliative care. Palliative care is specialized medical care focused on providing relief from symptoms and stress of a serious illness to improve quality of life for both the patient and the family. The Caucus will work to enhance access to palliative care services and improve the quality of life for millions of Americans.