Amend the Medicare "homebound" rule to allow some travel without loss of benefits

No changes have been made to homebound rules

Updated: Wednesday, January 13th, 2010 | By Robert Farley

We couldn't find any evidence that Medicare's "homebound" rule had been amended in the way President Barack Obama talked about in this promise. So we inquired at the Centers for Medicare and Medicaid Services.

Here's the e-mail response we got from Tony Salters, a spokesman for the centers:

"We're not aware of changes under consideration, but current law, mandated by Congress, says that a patient must be homebound in order to be eligible for Medicare"s home health benefit. Congress defined 'homebound' and any change to the eligibility requirement or definition would require congressional enactment."

Salter added that Obama's promise included a "confusing" definition -- that it "requires severely disabled recipients to stay in their homes to retain benefits."

"That doesn"t make sense and may confuse your audience," Salter wrote. "CMS doesn"t require patients to remain in the home to retain benefits. Rather, to be eligible for the home health benefit, a patient isn"t able to leave the home without a considerable and taxing effort. CMS has the responsibility and makes decisions to ensure that chronically disabled people, including those who are considered to be homebound, can live a full life without the fear of losing vital benefits.

"CMS"s Division of Home Health & Hospice reports that an individual is considered 'homebound' if the individual has a condition, due to illness or injury, that restricts the ability of the individual to leave their home except with the assistance of another individual or the aid of a supportive device, or if the individual has a condition that leaving the home is contraindicated and leaving the home requires a considerable and taxing effort and absences of the individual from the home (other than those approved absences defined in statute) are infrequent and of short duration."

In other words, the Obama promise is based on an oversimplification, or misunderstanding, of the definition of "homebound." In any case, as Salter noted, any changes to eligibility requirements would require congressional action, and we searched but could find no evidence of any legislative efforts along these lines.

And so we rate this promise Stalled.

Sources:

E-mail interview with Tony Salters, a spokesman for the Centers for Medicare and Medicaid Services, Jan. 13, 2009