Rosen, Murkowski Introduce Bipartisan Bill Expanding Palliative Care Training for National Health Service Corps Providers

WASHINGTON, D.C. – Today, U.S. Senators Jacky Rosen (D-NV) and Lisa Murkowski (R-AK), both members of the Senate Committee on Health, Education, Labor and Pensions, announced the introduction of their Provider Training in Palliative Care Act. This bipartisan legislation would allow members of the National Health Service Corps to defer their service for up to a year to do additional training in palliative care.

The Provider Training in Palliative Care Act is endorsed by key stakeholders, including AARP, American Cancer Society Cancer Action Network, C-TAC, National Association for Home Care and Hospice, National Partnership for Hospice Innovation, National Coalition for Hospice and Palliative Care, National Rural Health Association, and American Academy of Hospice and Palliative Medicine.

“As someone who stepped back from my career to take care of my parents and in-laws as they got older and started to have serious health problems, I understand just how important it is for patients and families to have access to care that is compassionate and comprehensive,” said Senator Rosen. “Palliative care helps provide comfort, manage pain and improve overall quality of life, yet providers are in short supply in Nevada and across the country. This important legislation will help fill health care gaps in Nevada caused by our doctor shortage by offering primary care providers a chance to receive training in palliative care so that they can better meet patient needs in underserved communities.”

“Unfortunately, projected shortages in providers trained in palliative care will likely have an outsized impact for Alaskans, as we already face such substantial challenges with access to providers. For patients with severe illness, the goal of palliative care is to minimize pain and discomfort while maximizing quality of life – a reality that will only exist if we have an adequate number of quality, professional caretakers,” said Senator Murkowski. “This legislation opens the door to primary care providers who want to train in palliative care, increasing the number of people trained in underserved areas all while ensuring the definition of primary care doesn’t change. We’re putting Alaskans with serious illnesses first.” 

Bill Dombi, President of the National Association for Homecare and Hospice: “NAHC applauds Senators Rosen and Murkowski for reintroducing the Provider Training in Palliative Care Act. Home-based providers of every kind, including those that deliver high-quality palliative care to people with serious illness, are facing unprecedented workforce challenges. We need creative solutions to expand training opportunities in the kind of holistic, person-and-family centered services that palliative care can provide. By making it easier for National Health Service Corp providers to pursue palliative care education, the bill would increase access to this much-needed care in some of the country’s most underserved communities.”

Jon Broyles, Executive Director of the Coalition to Transform Advanced Care (C-TAC): “The Coalition to Transform Advanced Care (C-TAC) is pleased to endorse the Provider Training in Palliative Care Act introduced by Senators Rosen and Murkowski. For many years, C-TAC has supported this legislation and its goal of expanding the number of health care professionals with palliative care training. This modified bill reflects a thoughtful bipartisan effort to reach the goal and the continued leadership of Senator Rosen in the serious illness field. We believe that enabling National Health Service Corps (NHSC) participants to defer their service for up to one year for a palliative fellowship or other palliative training opportunity will be a tipping point incentive for those who want to pursue palliative care in their careers,”

Tom Koutsoumpas, CEO of National Partnership for Hospice Innovation: “NPHI is proud to support Senators Rosen and Murkowski in their introduction of the Provider Training in Palliative Care Act. Given the ongoing implications of the COVID-19 pandemic and the exacerbated workforce shortages impacting the not-for-profit hospice and palliative care provider community, this legislation is imperative. NPHI strongly believes that palliative care and its documented benefits should be available to every individual regardless of cost or location and this legislation would help to accomplish that. We look forward to working with Senator Rosen, Senator Murkowski, the bipartisan Comprehensive Care Caucus, the HELP Committee, and others who support this critically important issue toward enactment into law.”

Amy Melnick, Executive Director, National Coalition for Hospice and Palliative Care: “Expanding the pool of trained palliative care physicians, PA’s, Nurse Practitioners and social workers is essential to increasing the equitable access to palliative care. Thank you Senator Rosen for spearheading the Provider Training in Palliative Care Act which would allow these essential palliative care team members to serve in the National Health Service Corps and provide care to people in the United States with limited access to healthcare.”

Nathan E. Goldstein, MD FAAHPM, President of the American Academy of Hospice and Palliative Medicine: “Given the critical shortage of health professionals with knowledge and skills in palliative care, AAHPM offers its strong support for the Provider Training in Palliative Care Act, which would provide an important update to the National Health Service Corps program. Allowing eligible individuals to postpone their service obligation to seek postgraduate training in palliative care will not only help ensure that we build a healthcare workforce more closely aligned with America’s evolving healthcare needs but build on a program which is vital to increasing access to care in rural and underserved areas. AAHPM applauds Sens. Rosen and Murkowski for their leadership in advancing this legislation, which stands to complement other current efforts to expand palliative care education and training through program and faculty development.” 

BACKGROUND: The bipartisan Provider Training in Palliative Care Act would allow participants in the National Health Service Corps program to defer their services for up to a year to do additional training in palliative care, so long as they provide primary care during their service with the Corps. Currently, participants are prohibited from deferring for training in palliative care, regardless of whether or not they continue to care for patients as a primary care provider.

Senator Rosen launched the bipartisan Comprehensive Care Caucus in 2019 to raise the public’s awareness and promote the availability and benefits of palliative care, while also finding bipartisan solutions to expand access to palliative care services, improve coordinated care, and address issues impacting caregivers. The Caucus’ mission is to work to enhance access to palliative care services and improve the quality of life of millions of Americans managing serious illnesses.

In July, the Senate Comprehensive Care Caucus introduced two pieces of legislation:

  • The Expanding Access to Palliative Care Act, would create a demonstration project in Medicare to allow palliative care to be covered concurrently with curative treatments for patients with serious illness or injury. Currently, patients on Medicare can only access palliative care through hospice. This legislation would provide comprehensive palliative care services much earlier in the course of illness, improving quality of life for the patient and their family and often also improving outcomes.
  • The Improving Access to Transfusion Care for Hospice Patients Act of 2021 would carve out payment for transfusion services within the hospice Medicare benefit, billing Medicare for transfusion separately. Patients needing this care would be able to continue to receive it outside of the hospice bundle, while still receiving full hospice benefits. Currently, many patients needing transfusions to maintain quality of life (due to conditions such as leukemia, lymphoma, or myeloma) often wait much longer to opt into hospice because they can lose access to transfusion care when they do so, given that such care currently is paid for out of a capped hospice benefit amount. Hospices are allowed to cover transfusions, but it is very costly, so few patients can afford to do so on a regular basis when in hospice care.