In Opinion Piece, Former Sen. Dole Calls for Revision of Medicare Homebound Restriction

A rule requiring Medicare beneficiaries to be "homebound" to receive home health services reflects an "outmoded view of life" for people with disabilities and should be amended, former Sen. Bob Dole (R-Kan.) writes in an opinion piece in the Washington Post. Dole writes that the homebound restriction was intended to "deter abuse" by limiting Medicare home health services to beneficiaries with "severe" illnesses or disabilities for whom leaving home would require "a considerable and taxing effort." According to Dole, the rule "reflected the limits" of health care and technology when it was created in the 1960s, but technological advances and "greater community accessibility" now allow people with "the most severe" disabilities to leave their homes for work, volunteer activities and social interaction. Dole contends that the "outdated" policy has turned nurses, doctors and home health administrators -- who are required to report "any knowledge of their patients leaving their homes" -- into "watchdogs" and caused contractors to "err on the conservative side, ... strip[ping] home health coverage from those most needing it." Dole adds that "thousands" of beneficiaries receiving home health services "live in fear of leaving their homes" because of these requirements. He urges the House of Representatives to "amend this harsh restriction on individual freedom" by including Rep. Ed Markey (D-Mass.) and Sen. Susan Collins' (R-Maine) David Jayne Amendment, also known as the Homebound Clarification Act of 2001 (HR 1490), in the Medicare reform bill. Dole concludes that an amendment to provide for those who are "severely and permanently" disabled or require assistance from an attendant or skilled nursing facility should give HHS six months to make recommendations on how to bring the homebound rule "up to date with today's technology" (Dole, Washington Post, 6/27).