Congressmen Chris Smith and Ed Markey – the Co-Founders and Co-Chairmen of the Bipartisan Congressional Alzheimer’s Task Force – today introduced legislation to modify a Medicare provision that keeps thousands of disabled persons unfairly locked up inside of their homes.

    The Markey/Smith bill – also known as the David Jayne Hometown Hero Act – will set new guidelines that preserve medical requirements but ease other rigid standards that prohibit Medicare beneficiaries from qualifying for home healthcare if they step outside their doors.  It would replace existing law that says beneficiaries can only leave the home for “infrequent” trips.

    The problem with the current law is that beneficiaries who need home healthcare to survive risk losing the benefit if they leave their home for any purpose other than a doctor’s appointment, religious service, or adult daycare session.

    “Our goal is simple.  We want to make sure that Medicare beneficiaries who require home healthcare in order to stay out of a nursing home will not have to live in fear that they will have this lifeline snatched away if they dare to set foot outside of their home,” Smith said. 

    “Furthermore, the bill is very specific with regard to the medical condition required of patients to receive home healthcare via Medicare.  These requirements, as well as penalties for physicians who file false information to support a bogus claim, will ensure that the revisions are tough on cheaters yet compassionate on patients,” he added.

    The case of David Jayne, whom the bill is named after, highlights the need for this corrective legislation.  Jayne, a Georgia resident who can only move three fingers and speaks using a computer, has suffered from amyotrophic lateral sclerosis (ALS) since 1987.  Through the use of technology, the help of friends, and home healthcare providers, Jayne has defied the odds for ALS patients.  But when he canceled a doctor’s appointment to attend a friend’s funeral, Jayne had his home healthcare services taken away.

    Jayne had his services restored and he is now leading the national fight to rectify this flaw in Medicare.

    “David Jayne is a hero and we owe it to him to pass this legislation into law so thousands of other people in the same predicament are not unfairly penalized,” Smith said. 

    “We believe that the eligibility criteria for home healthcare should be based on medical necessity, not arbitrary definitions of how many times a patient leaves the home.  We also know that trips outside of the home – perhaps to attend a child or grandchild’s little league game, visit a friend, or feel the salt air of the shore – can boost the morale and mind-set of patients with debilitating conditions such as Alzheimer’s or ALS,” he added.