National Association for Home Care & Hospice 2016 Legislative Blueprint for Action

NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE 2016 LEGISLATIVE BLUEPRINT FOR ACTION

NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE 2016 LEGISLATIVE BLUEPRINT FOR ACTION i

TABLE OF CONTENTS i

ABOUT THE BLUEPRINT viii

I. ENSURE ENACTMENT OF A COMPREHENSIVE, HOME-BASED NATIONAL HEALTH CARE POLICY 1

A. HEALTH CARE COVERAGE/LONG TERM CARE DELIVERY AND FINANCING 2

ENSURE HOME CARE AND HOSPICE PARTICIPATION IN TRANSITIONS IN CARE, ACCOUNTABLE CARE ORGANIZATIONS, CHRONIC CARE MANAGEMENT, HEALTH INFORMATION EXCHANGES, AND OTHER HEALTH CARE DELIVERY REFORMS 2

ENACT A COMPREHENSIVE, HIGH QUALITY HOME- AND COMMUNITY-BASED LONG-TERM CARE PROGRAM 4

MODIFY EMPLOYER RESPONSIBILITIES IN HEALTH CARE REFORM TO ADDRESS HOME CARE SPECIFIC NEEDS 7

ESTABLISH FEDERAL SUPPORT FOR SMALL BUSINESS EMPLOYEE HEALTH INSURANCE 10

B. MEDICARE 11

ESTABLISH A CHRONIC CARE MANAGEMENT BENEFIT UNDER MEDICARE 11

ESTABLISH A HOME AND COMMUNITY-BASED DEMONSTRATION PROGRAM UNDER MEDICARE 14

CREATE A PHARMACEUTICAL SERVICE HOME HEALTH BENEFIT 15

C. MEDICAID 16

REQUIRE TRANSPARENCY IN THE STATE PLAN AMENDMENT PROCESS 16

REQUIRE MEDICAID HOME CARE PROGRAMS TO MEET QUALITY OF CARE STANDARDS AND OFFER A FULL RANGE OF DELIVERY MODELS 17

ENSURE ACCESS TO HOME CARE IN MEDICAID MANAGED LONG TERM SERVICES AND SUPPORTS 19

ESTABLISH FEDERAL STANDARDS FOR MEDICAID PERSONAL CARE SERVICES 21

REFORM MEDICAID HOME HEALTH FACE-TO-FACE ENCOUNTER REQUIREMENT 22

ESTABLISH MEDICAID HOME CARE AS A MANDATORY BENEFIT AND SUPPORT REBALANCING OF LONG TERM SERVICES AND SUPPORTS EXPENDITURES IN STATE MEDICAID PROGRAMS IN FAVOR OF HOME CARE 24

SUPPORT AN INCREASE IN THE FEDERAL MEDICAID MATCH (FMAP) AND OPPOSE CAPS ON FEDERAL PAYMENTS 26

ENSURE APPROPRIATE MEDICAID RATES FOR HOME CARE AND HOSPICE 28

REQUIRE MEDICAID MANAGED CARE ORGANIZATIONS TO RECEIVE STATE APPROVAL BEFORE LOWERING PAYMENT RATES FOR HOME CARE SERVICES 30

REJECT MEDICAID WAIVERS THAT REDUCE BENEFITS FOR CURRENT BENEFICIARIES 31

EXEMPT HOME CARE AND HOSPICE FROM COST-SHARING BY MEDICAID BENEFICIARIES 32

ESTABLISH MINIMUM FEDERAL STANDARDS FOR HOME HEALTH COVERAGE UNDER MEDICAID 33

REQUIRE COVERAGE OF HOME CARE, HOSPICE AND PERSONAL CARE SERVICES IN ANY MEDICAID REFORM 34

EXTEND SPOUSAL IMPOVERISHMENT PROTECTIONS TO HOME CARE 35

ESTABLISH REASONABLE STANDARDS FOR CONSOLIDATION OF MEDICARE FEE-FOR-SERVICE PAYMENTS WITH MEDICAID FOR DUAL-ELIGIBLE BENEFICIAIRES 36

D. PROTECTING CONSUMERS/QUALITY OF CARE 37

OPPOSE PUBLIC AUTHORITIES OR OTHER MEASURES THAT RESTRICT CONSUMER CHOICE OF PROVIDER IN THE PROVISION OF LONG TERM CARE SERVICES 37

REQUIRE NON-DISCRIMINATION IN MEDICAID HOME CARE ELIGIBILITY 39

REQUIRE CONTRACTORS OF HOME CARE SERVICES AND/OR CONSUMER-DIRECTED HOME CARE SERVICES TO ENSURE QUALITY AND SUPERVISION OF SUCH SERVICES 40

ENHANCE CONSUMER PROTECTIONS FOR HOME CARE RECIPIENTS 42

ELIMINATE ELDER ABUSE 44

ENCOURAGE STATES TO ADOPT HOME CARE QUALITY OF CARE STANDARDS THROUGH VOLUNTARY ACCREDITATION OR LICENSURE LAWS 45

REQUIRE COMMUNITY PARAMEDICS THAT PROVIDE NON-EMERGENCY SERVICES IN THE HOME TO MEET REGULATORY AND LICENSING HOME CARE STANDARDS 46

REQUIRE MEDICAID MANAGED CARE ORGANIZATIONS TO CONTRACT WITH ANY WILLING AND QUALIFIED PROVIDER 48

DEVELOP STANDARD QUALITY METRICS AND MINIMUM MANDATORY UNIFORM DATA SETS 49

E. CAREGIVER SUPPORT 50

PROMOTE RESPITE CARE FOR FAMILY CAREGIVERS 50

SUPPORT TAX INCENTIVES FOR FAMILY CAREGIVERS 52

F. VETERANS/MILITARY 53

IMPROVE HOME CARE SERVICES FOR VETERANS 53

EVALUATE THE IMPLEMENTATION OF THE HOME CARE BENEFIT IN THE MILITARY HEALTH SERVICES SYSTEM 55

G. LONG TERM CARE INSURANCE 56

ESTABLISH MEANINGFUL STANDARDS FOR LONG-TERM CARE INSURANCE 56

H. CHILDREN’S SERVICES 58

MONITOR STATES’ COMPLIANCE WITH IDEA OBLIGATIONS 58

IMPROVE REIMBURSEMENT REQUIREMENTS FOR PEDIATRIC HOME CARE UNDER MEDICAID 59

PROVIDE ACCESS TO HOME CARE SERVICES FOR PEDIATRIC PATIENTS WITH MORE INTENSIVE CARE NEEDS 60

II. PROMOTE EFFICIENT USE AND ENSURE ADEQUATE SUPPLY OF QUALIFIED HOME CARE AND HOSPICE PERSONNEL 61

SUPPORT PROPOSALS THAT WILL SUPPLY A STABLE, DIRECT CARE WORKFORCE PROVIDING QUALITY CARE FOR LONG-TERM CARE CONSUMERS 62

REQUIRE MEDICAL RESIDENTS AND INTERNS TO HAVE HOME CARE AND HOSPICE EXPERIENCE AS PART OF THEIR GRADUATE MEDICAL EDUCATION 63

PRESERVE WORKERS’ RIGHTS AND PRIVACY PROTECTIONS IN THE FORMATION OF UNIONS 64

RESTORE THE COMPANIONSHIP SERVICES EXEMPTION TO THE FAIR LABOR STANDARDS ACT 65

PROVIDE SUFFICIENT HOME CARE AND HOSPICE PAYMENTS SO THAT AGENCIES CAN PROVIDE APPROPRIATE WAGES AND BENEFITS TO CLINICAL STAFF 67

ENSURE AVAILABILITY OF HOME CARE AND HOSPICE PERSONNEL TO MEET THE GROWING NEEDS OF THE BABY BOOM GENERATION, PARTICULARLY IN RURAL AND OTHER UNDERSERVED AREAS 68

COORDINATE HOME HEALTH AIDE AND NURSING HOME AIDE TRAINING REQUIREMENTS 70

STRENGTHEN THE HOME HEALTH AIDE TRAINING REQUIREMENTS CONTAINED IN OBRA-87 AND APPROPRIATELY REIMBURSE AGENCIES FOR TRAINING COSTS 71

ALLOW LPNs /LVNs TO SUPERVISE HOME CARE AIDES 73

PREVENT VIOLENCE AGAINST HOME CARE WORKERS 74

REQUIRE FEDERALLY FUNDED CRIMINAL BACKGROUND CHECKS AND ESTABLISH A NATIONAL REGISTRY SYSTEM 76

ESTABLISH STABILITY AND EQUITY AMONG MEDICARE HEALTH CARE PROVIDERS IN APPLICATION OF THE WAGE INDEX 78

III. ENSURE THE APPROPRIATE USE OF TECHNOLOGY IN HOME CARE 81

RECOGNIZE TELEHOMECARE INTERACTIONS AS BONA FIDE MEDICARE AND MEDICAID SERVICES 82

PROVIDE FINANCIAL ASSISTANCE TO HOME CARE AND HOSPICE PROVIDERS TO EXPAND USE OF INFORMATION TECHNOLOGIES AND IMPLEMENT ELECTRONIC HEALTH RECORDS 85

ALLOW PAYMENT FOR HOME HEALTH SERVICES FOR CENTER- BASED CARE FOR TECHNOLOGY-DEPENDENT CHILDREN 87

COVER APPROPRIATE SELF-CARE TECHNOLOGIES UNDER MEDICARE 88

FINANCE A RESOURCE CENTER FOR HOME TELEHEALTH TECHNOLOGIES 89

IV. RECOGNIZE THE APPROPRIATE ROLE OF HOME CARE AND HOSPICE AS PART OF ANY DISASTER PREPAREDNESS AND RESPONSE STRATEGY 90

DEVELOP A SYSTEM THAT INCLUDES THE NATIONAL HOME CARE AND HOSPICE NETWORK TO PROMOTE EFFECTIVE PREPAREDNESS FOR ANY RESPONSE TO NATURAL AND MANMADE DISASTERS 91

V. ENSURE APPROPRIATE PAYMENT POLICY AND REGULATION OF HOME CARE AND HOSPICE WHILE EASING THE PAPERWORK BURDEN AND DUPLICATIVE STATE AND FEDERAL REQUIRMENTS 94

A. MEDICARE COVERAGE, ACCESS AND ELIGIBILITY 95

PRESERVE THE PUBLIC NATURE OF THE MEDICARE PROGRAM 95

ABOLISH THE INDEPENDENT MEDICARE PAYMENT ADVISORY BOARD 97

ESTABLISH REASONABLE STANDARDS FOR REBASING MEDICARE HOME HEALTH SERVICES PAYMENT RATES 98

ENACT A MEDICARE OPERATED PRESCRIPTION DRUG BENEFIT UNDER TRADITIONAL MEDICARE WITH AUTHORITY TO NEGOTIATE PRESCRIPTION DRUG PRICES 100

MAKE PERMANENT THE ADD-ON FOR SERVICES TO RURAL PATIENTS; ENSURE CARE ACCESS FOR RURAL AND UNDERSERVED PATIENTS 101

OPPOSE A “SICK TAX”—BLOCK EFFORTS TO IMPOSE A FEE TO BE PAID BY PATIENTS TO ACCESS MEDICARE HOME HEALTH SERVICES 103

ANY RESTRUCTURING OF MEDICARE COST SHARING SHOULD NOT LEAD TO BARRIERS TO HOME HEALTH SERVICES OR HOSPICE CARE 106

ENACT A HOMEBOUND DEFINITION THAT ENSURES ACCESS AND ELIGIBILITY FOR NEEDED HOME HEALTH SERVICES 107

ALLOW PAYMENT FOR HOME HEALTH SERVICES FOR THOSE RECEIVING ADULT DAY CARE 109

MAKE OCCUPATIONAL THERAPY AND SOCIAL WORK SERVICES QUALIFYING SERVICES FOR MEDICARE HOME HEALTH 111

B. MEDICARE PAYMENT METHODOLOGY 113

REFINE MEDICARE HOME HEALTH PPS OUTLIER PAYMENT 113

ENSURE APPROPRIATE DEVELOPMENT OF PERFORMANCE-BASED PAYMENT FOR MEDICARE HOME HEALTH SERVICES 115

REFORM ANNUAL MEDICARE INFLATION UPDATE CALCULATION METHOD 117

ESTABLISH TRANSPARENT AND ACCURATE PROCESSES FOR MODIFICATION OF PPS PAYMENT RATES AND CASE-MIX ADJUSTMENTS 119

REJECT RISK-SHARING UNDER HOME HEALTH PPS 121

ENSURE AN EQUITABLE PPS WITH AN ADEQUATE CASE-MIX ADJUSTOR 123

ENSURE THE FULL MARKET BASKET UPDATE FOR HOME HEALTH PAYMENTS 125

ENSURE THAT PROPOSALS TO “BUNDLE” POST-ACUTE BENEFIT PAYMENTS OFFER OPPORTUNITIES FOR HOME HEALTH AGENCY PARTICIPATION 128

OPPOSE THE INSTITUTION OF UNTARGETED MEDICARE HOME HEALTH PRIOR AUTHORIZATION 130

C. MEDICARE ADVANTAGE 131

ESTABLISH PROVIDER APPEAL RIGHTS IN MEDICARE ADVANTAGE 131

LIMIT MEDICARE ADVANTAGE PLAN REIMBURSEMENT TO THE COST OF CARE UNDER TRADITIONAL MEDICARE 132

RESTRICT EXORBITANT COST-SHARING IN MEDICARE PRIVATE FEE-FOR-SERVICE PLANS 133

REQUIRE MEDICARE ADVANTAGE PLANS TO PROVIDE A HOME HEALTH BENEFIT FULLY EQUIVALENT TO ORIGINAL MEDICARE 135

RESTRICT PASSIVE ENROLLMENT OF DUAL ELIGIBLES IN MEDICARE ADVANTAGE PLANS 136

PROVIDE ACCESS TO MEDICARE ADVANTAGE ENROLLMENT INFORMATION/ESTABLISH A PROVIDER “HOLD HARMLESS” 137

D. MEDICAID AND MEDICARE ADMINISTRATION 138

ENSURE TIMELY HEARINGS AND DECISIONS BY MEDICARE ADMINISTRATIVE LAW JUDGES 138

PROVIDE ACCESS TO MEDICAID ENROLLMENT INFORMATION 139

ALLOW FEDERAL JUDICIAL REVIEW OF STATE MEDICAID PROGRAM COMPLIANCE WITH FEDERAL MEDICAID LAW 140

STRENGTHEN REQUIREMENTS FOR PUBLICATION OF POLICY CHANGES BY CMS 142

OPPOSE USER FEES FOR MEDICARE AND MEDICAID ADMINISTRATIVE ACTIVITIES 143

ESTABLISH PROVIDER, CAREGIVER, AND CONSUMER BILLS OF RIGHTS IN ALL FEDERALLY-FINANCED HOME CARE AND HOSPICE PROGRAMS 144

ENACT MEDICAID HOME CARE AND HOSPICE PROGRAM INTEGRITY MEASURES 145

ESTABLISH REASONABLE STANDARDS FOR ELECTRONIC VISIT VERIFICATION 147

E. REGULATORY BURDENS/PAPERWORK 148

REPEAL OR REFORM MEDICARE HOME HEALTH FACE-TO-FACE ENCOUNTER REQUIREMENT 148

REQUIRE MULTI-STATE RECIPROCITY IN MEDICARE SURVEY CONTRACTS 151

ALLOW FLEXIBILITY IN THE DELIVERY OF HOME HEALTH SERVICES UNDER THE MEDICARE PROSPECTIVE PAYMENT SYSTEM 152

FULLY REIMBURSE OASIS COSTS, STREAMLINE OASIS REQUIREMENTS, AND CONDUCT RESEARCH ON OASIS VALIDITY 154

INCREASE FLEXIBILITY IN THE APPLICATION OF THE HOME HEALTH CONDITIONS OF PARTICIPATION 156

ENSURE ACCESS TO HOME CARE AND FULL FEDERAL FUNDING IN ANY PROPOSALS TO REQUIRE MEDICAL DIRECTORS IN HOME HEALTH AGENCIES 158

MODERNIZE MEDICARE HOME HEALTH AGENCY “ONE SERVICE DIRECTLY” STANDARD 159

LIMIT ADMINISTRATIVE BURDENS ON HOME HEALTH AGENCIES 160

COORDINATE GOVERNMENT REVIEWS OF HOME HEALTH AGENCIES TO REDUCE PAPERWORK BURDEN 161

ALLOW NURSE PRACTITIONERS, CLINICAL NURSE SPECIALISTS, CERTIFIED NURSE MIDWIVES AND PHYSICIANS’ ASSISTANTS TO CERTIFY MEDICARE HOME HEALTH PLANS OF CARE 162

OPPOSE USER FEES FOR MEDICARE AND MEDICAID ADMINISTRATIVE ACTIVITIES 163

PROHIBIT USE OF SAMPLING AUDITS 164

F. PROTECTIONS FOR CONSUMERS, PROVIDERS AND CAREGIVERS 166

PROMOTE MEDICARE-MEDICAID COORDINATION 166

SUPPORT ADEQUATE FUNDING OF MEDICARE ADMINISTRATIVE ACTIVITIES 168

PROHIBIT SUSPENSION OF PAYMENT IN SUSPECTED OVERPAYMENT CASES 169

LIMIT RETROACTIVE RECOVERIES RELATED TO THE IMPLEMENTATION OR MODIFICATION OF MEDICARE PPS 171

REFORM STANDARDS FOR HEALTH CARE SERVICES LIABILITY 173

ALLOW PROVIDER APPEALS PRIOR TO SANCTIONING FOR SURVEY AND CERTIFICATION DEFICIENCIES 174

REINSTATE THE PRESUMPTIVE STATUS FOR HOME HEALTH WAIVER OF LIABILITY 176

PROHIBIT STATES FROM USING COSTLY INDIVIDUAL CLAIMS REVIEW IN THIRD-PARTY PAYER RECOVERY EFFORTS 178

PERMIT SUITS AND AUTHORIZE PUNITIVE DAMAGES AGAINST MEDICARE CONTRACTORS FOR BAD FAITH DECISIONS 180

REINFORCE BENEFICIARY DUE PROCESS RIGHTS 181

PRESERVE INDEPENDENCE OF ADMINISTRATIVE LAW JUDGES 182

IMPROVE ACCESS TO JUDICIAL REVIEW FOR MEDICARE CLAIMS 183

ALLOW APPROPRIATE AND EXPEDITED JUDICIAL REVIEW OF MEDICARE REIMBURSEMENT POLICY DISPUTES 185

ENSURE AND ENFORCE BENEFICIARY CHOICE IN ALL FEDERAL HEALTH CARE PROGRAMS 187

ENSURE PATIENTS’ RIGHTS AND “TRUTH IN COVERAGE” IN MANAGED CARE PLANS 188

PROTECT CONSUMERS FROM ERRONEOUS SERVICE AND COVERAGE DETERMINATIONS 190

PROTECT PATIENTS’ FREEDOM TO CHOOSE IN MANAGED CARE PLANS 191

PROHIBIT GAG RULES IN MANAGED CARE CONTRACTS 193

MODIFY PREEMPTION PROVISION OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT 194

AMEND THE EMPLOYEE RETIREMENT INCOME SECURITY ACT TO REQUIRE DIRECT PROVIDER APPEAL RIGHTS 195

AUTHORIZE PUNITIVE DAMAGES LAWSUITS FOR BAD FAITH INSURANCE DECISIONS 196

G. PRIVATE INSURANCE 197

REQUIRE COVERAGE OF HOME HEALTH CARE AND HOSPICE AS ESSENTIAL HEALTH INSURANCE BENEFITS 197

H. STUDIES 198

CONDUCT IN-DEPTH STUDY OF VARIATION IN HOME HEALTH SERVICE USE AND OUTCOMES IN MEDICARE MANAGED CARE AS COMPARED TO THE FEE-FOR-SERVICE SECTOR 198

EXPAND STUDY OF QUALITY, COST EFFECTIVENESS OF POST- ACUTE PROVIDERS 199

I. QUALITY AND INTEGRITY OF CARE 200

EVALUATE USE AND ACCURACY OF HOME HEALTH COMPARE 200

ENACT MEDICARE HOME HEALTH AND HOSPICE PROGRAM INTEGRITY MEASURES 202

ENACT MEDICAID HOME CARE AND HOSPICE PROGRAM INTEGRITY MEASURES 204

VI. ENSURE A CENTRAL ROLE FOR HOME CARE RELATIVE TO WELLNESS AND PREVENTION OF DISEASE 206

ALLOW HOME CARE AGENCIES TO SERVE AS CASE MANAGERS IN FEDERALLY-FUNDED PROGRAMS 207

CREATE A NUTRITIONAL SERVICES HOME HEALTH BENEFIT 208

VII. ENSURE THE AVAILABILITY OF HOSPICE AND PALLIATIVE CARE FOR ALL AMERICANS NEAR THE END OF LIFE 210

ENACT THE PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING ACT 211

REJECT EFFORTS TO INCLUDE HOSPICE AS PART OF MEDICARE ADVANTAGE BENEFIT PACKAGE 213

REVISE REQUIREMENTS FOR HOSPICE FACE-TO-FACE ENCOUNTERS 215

ENSURE THE FULL MARKET BASKET UPDATE FOR THE MEDICARE HOSPICE BENEFIT 217

REJECT ADDITIONAL BENEFICIARY COST SHARING FOR HOSPICE SERVICES UNDER MEDICARE REFORM EFFORTS 220

ENSURE ACCESS TO CARE FOR RURAL HOSPICE PATIENTS; ESTABLISH ROLE FOR PAs IN HOSPICE CARE 221

OVERSEE THE IMPACT OF HOSPICE PAYMENT REFORM; REJECT REBASING AND SITE-OF-SERVICE ADJUSTMENT FOR NF RESIDENTS 223

PROVIDE FULL DISCLOSURE OF HOSPICE AVAILABILITY AND CHOICE OF HOSPICE PROVIDER TO TERMINALLY ILL BENEFICIARIES RESIDING IN SNFs/NFs 225

ENSURE ACCESS TO MEDICATIONS NECESSARY FOR PAIN CONTROL 226

ALLOW PAs TO SERVE AS HOSPICE ATTENDING PHYSICIANS AND NPs AND PAs TO CERTIFY/RECERTIFY PATIENTS FOR MEDICARE HOSPICE SERVICES 227

PROTECT AND EXPAND HOSPICE COVERAGE UNDER MEDICAID 228

PROTECT HOSPICE AGENCIES FROM THE IMPACT OF SEQUENTIAL BILLING 229

OPPOSE IMPOSITION OF PENALTIES FOR ERRONEOUS CERTIFICATION OF TERMINAL ILLNESS 230

OVERSEE HOSPICE QUALITY REPORTING PROGRAM 231

SUPPORT THE PORTABILITY OF ADVANCE DIRECTIVES; CREATE AN ADVANCE CARE PLANNING BENEFIT UNDER MEDICARE 233

ENACT HOSPICE-SPECIFIC COMPLIANCE MEASURES 235

VIII. HOME MEDICAL EQUIPMENT 236

SUPPORT EFFORTS TO ADEQUATELY REIMBURSE HME SUPPLIERS FOR COSTS ASSOCIATED WITH IN–HOME DRUG THERAPIES 237

REVISE APPLICATION OF THE “IN-HOME” RESTRICTION FOR MEDICARE PART B REIMBURSEMENT OF DME SUPPLIES 239

REFINE COMPETITIVE BIDDING FOR HOME MEDICAL EQUIPMENT 240

ENSURE ADEQUATE REIMBURSEMENT FOR OXYGEN AND OXYGEN SUPPLIES 242

IX. FACT SHEETS ON HOME CARE 243

HOME CARE AND HOSPICE LEGISLATION 2013/14 244

HOME CARE LEGISLATION 2012 245

HOME CARE LEGISLATION 2011 246

HOME CARE LEGISLATION 2010 247

HOSPICE LEGISLATION 2011 253

HOME HEALTH LEGISLATION 2009-2010 256

HOSPICE LEGISLATION 2009-2010 260

HOME HEALTH LEGISLATION 2008 262

HOME HEALTH LEGISLATION 2007 263

HOME HEALTH LEGISLATION 2006 264

HOME HEALTH LEGISLATION 2005 266

HOME HEALTH LEGISLATION 2003 277

HOME HEALTH LEGISLATION 2002 280

HOME HEALTH LEGISLATION 2001 282

HOME HEALTH LEGISLATION 2000 283

HOME HEALTH LEGISLATION 1999 288

HOME HEALTH LEGISLATION 1998 291

HOME HEALTH LEGISLATION 1997 293

HOME HEALTH LEGISLATION 1996 300

HOME HEALTH LEGISLATION 1995 301

HOME HEALTH LEGISLATION 1994 302

HOME HEALTH LEGISLATION 1993 303

HOME HEALTH LEGISLATION 1992 305

HOME HEALTH LEGISLATION 1991 307

HOME HEALTH LEGISLATION 1990 308

HOME HEALTH LEGISLATION 1989 315

HOME HEALTH LEGISLATION 1988 318

HOME HEALTH LEGISLATION 1987 322

HOME HEALTH LEGISLATION 1985—1986 328