The Man Who Rewrote Medicare Home Health Law | Bill Dombi on 50 Years of Fighting for Home Care

For nearly five decades, Bill Dombi has shaped almost every major law, regulation, and legal battle behind home health and hospice care in America. As former President and CEO of the National Association for Home Care & Hospice (NAHC) and now senior counsel at Arnall Golden Gregory, Bill has argued in front of Congress, CMS, and the courts to protect access to care at home. In this episode, Bill sits down with Tom Maxwell to reveal the untold history of the industry, including the landmark Duggan v. Bowen lawsuit that rewrote Medicare home health coverage, the last-minute decision that almost kept home health out of Medicare entirely, and the uphill battle to create the Medicare Hospice Benefit in 1983. Topics covered: • The origin story of Medicare home health coverage • Duggan v. Bowen and the fight to expand home health eligibility • Creating the Medicare Hospice Benefit • Operation Restore Trust and hospice fraud today • Medicare Advantage's impact on home health and hospice providers • The future of value-based care • AI's role in clinical and operational efficiency • Advice for the next generation of home care and hospice leaders About the guest: William "Bill" Dombi served as President and CEO of the National Association for Home Care & Hospice (NAHC) from 2018 until its merger with NHPCO, forming the National Alliance for Care at Home. Prior to that, he spent decades as NAHC's Vice President for Law. He was lead counsel in landmark litigation expanding Medicare home health coverage and helped shape the Medicare Hospice Benefit. He now serves as senior counsel at Arnall Golden Gregory LLP and sits on the board of advisors for New Day Healthcare. Connect with Bill: • LinkedIn:   / bill-dombi-45601510   • Email: wadombi10@gmail.com Chapters: 0:00 Welcome Bill Dombi to the show 1:44 What first drew Bill to home care advocacy 4:05 Bill's proudest career accomplishments 9:08 Bill Dombi outside of Washington 11:09 The patient story that defines his mission 12:43 Sponsor Break 13:42 The hardest battle: creating the hospice benefit 18:49 What almost happened: home health nearly left out of Medicare 21:31 Why healthcare fraud keeps happening 23:41 Sponsor Break 24:55 The biggest threat to home health: stagnation 28:09 Is hospice at a crossroads? 35:24 Medicare Advantage: is it really an advantage? 42:32 Where AI actually helps in home-based care 48:41 If Bill could rewrite one regulation 52:53 Sponsor Break 54:45 Einstein the hospice therapy dog 56:11 How Bill stayed optimistic for 50 years 59:35 What Bill is doing today 1:04:37 How to reach Bill Dombi Check out Last Visit First on other platforms: • Apple Podcasts: https://podcasts.apple.com/us/podcast... • Spotify: https://open.spotify.com/show/3iSKGRv... • YouTube:    / @lastvisitfirstpodcast   • Website: https://lastvisitfirst.com • LinkedIn:   / last-visit-first   Sponsors: • Premier Sponsor: Homecare Homebase: https://lastvisitfirst.com/go/HCHB • Premier Sponsor: Trella Health: https://www.trellahealth.com/demo/ • Maxwell TEC: https://maxwelltec.com/products/nanac... • IntellaTriage: https://intellatriage.com/