Congress established the Medicare Hospice Benefit in 1983 to ensure that all Medicare beneficiaries could access high-quality end-of-life care. Today, more than 65 percent of hospice patients are Medicare beneficiaries. The Medicare Hospice Benefit offers dying Americans the option to experience death free of pain, with emotional and spiritual support for both themselves and their families.
Video: Medicare & You: National Hospice and Palliative Care Month
Entrenched Hospice Interests Oppose Hospice Cap Reform, and Any Hospice Reform. Why?
Oh and by the way, Medicare’s hospice eligibility criteria have never been empirically tested, are seriously flawed and result in long length of stay for non-cancer patients who are given a timely choice. This causes hospices that honor those criteria to hit the Cap. Consequently hospices are inventing their own eligibility criteria and, today, hospice eligibility standards vary by state, by community and by hospice. So, if you’re terminally ill and eligible for hospice in Los Angeles, you may or may not be eligible in New York or Chicago or Phoenix.
Prohibitive Medicare Reimbursement May Restrict Hospice Enrollment in Patients Requiring High
The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation’s oldest, largest and most-respected voluntary hospitals. In 2011, US News and World Report ranked The Mount Sinai Hospital 14th on its elite Honor Roll of the nation’s top hospitals based on reputation, safety, and other patient-care factors. Mount Sinai is one of 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and US News and World Report and whose hospital is on the US News and World Report Honor Roll. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.
Medicare covers hospice & comfort care
, your loved one can get the care and support they need. This can include doctor and nursing services, counseling, medical supplies, pain medications, and other services. And, most importantly, hospice can provide much needed comfort while at home.
Audit Finds Wrong Part Of Medicare Was Used To Pay For Hospice Patients’ Drugs
Modern Healthcare: Auditors Find Possible Excess Medicare Payments The Medicare program could be paying multiple times for prescription drugs for hospice beneficiaries, a new federal report suggests. HHS’ inspector general’s office conducted a nationwide review of prescription drugs for hospice beneficiaries between January and December 2009 and found that Medicare Part D paid for a variety of prescription medications — including analgesic, anti-nausea, laxative and anti-anxiety drugs and drugs to treat chronic obstructive pulmonary disease — that should have been covered under the per diem payments made to hospice organizations under Medicare Part A (Zigmond, 7/4).
Is it time for another lawsuit? Advocating to change the Medicare Hospice Benefit eligibility requirements
I have decided that there is compelling evidence that the Medicare Hospice eligibility requirements are outdated and need to be re-written. These policies are not driven by patient need and the evidence is mounting that limiting access to hospice and palliative services actually increases the cost of health care at the end of life. Those with concerns about the rise in the cost of the Medicare Hospice Benefit appear to put undue focus on the increasing length of stay of a number of hospice patients without considering that hospice and palliative care can be more cost effective than usual care. This cost reduction does not come from “irrationally rationing” health care but by facilitating conversations that allow patients and families to understand prognosis and verbalize preferences and goals about end-of-life care. These conversations enable health care providers to guide patients away from costly treatments and interventions that do not facilitate attainment of patients’ goals or add to the quality or length of their lives. If you agree that it is time for a change to the eligibility requirements, what can we do as hospice and palliative medicine providers to advocate for our patients to receive high-quality palliative and end-of-life care in a manner that makes sense? Do we wait until the results of the concurrent care demonstration project are in? Do we ask AAHPM, NHPCO, and HPNA’s Public Policy and Advocacy Committees to weigh in on the matter? Or do we wait until the lawyers file another class-action lawsuit against Medicare? by: Shaida Talebreza Brandon (all opinions expressed are my own)
Benefits of Medicare Hospice Services
WAXAHACHIE, TX—U.S. Rep. Joe Barton (second from left) meets with area staff members at Odyssey Hospice’s South Dallas office to learn more about the ways that Medicare-supported hospice services can benefit Texans with life-limiting illnesses. Among those attending the session were (left to right): Seeley Avery, Odyssey’s Regional Vice President-Sales; Rep. Barton; Pamela Bailey, Quality Manager; Jennifer Leggett, Account Executive; Larry Chesney, Clinical Liaison; Doris Barnes, Registered Nurse; Mark Cook, Area Vice President-Sales; and Trivia Spencer, Community Liaison.
Updating the Medicare Hospice Benefit
This also makes the physician’s decision to request hospice more difficult. In its current form, a physician requesting that their patient seek hospice care means that she believes that curative treatments are no longer beneficial. While this is likely true, the firm line that has to be crossed by patient and physician can likely be misunderstood as the doctor giving up on their patient. The current system creates an artificial distinction between curative treatments and care geared towards the patient’s emotional needs while providing care to ensure their comfort. Even in Medicare Advantage, a program that promotes coordinated, streamlined care through its capitated payment system, the Medicare hospice benefit is excluded. A patient enrolled in Medicare Advantage who elects hospice care reverts back to regular fee-for-service Medicare.
CMS to Host Home Health Open Door Forum on Jan. 9th
The Forum addresses the concerns of three unique health care areas within the Medicare and Medicaid programs. Issues related to Home Health PPS, the newly proposed competitive bidding for DME, and the Medicare Hospice benefit are all topics the forum has covered. Many of the issues covered bridge concerns within all three settings, and the combination of the topics under one Forum has been useful to many participants. Timely announcements and clarifications regarding important rulemaking, agency program initiatives, and other related areas are also included in the forums.
Growing Pains for the Medicare Hospice Benefit
For 30 years, the Medicare hospice benefit has played a key role in shaping end-of-life care in the United States. Authorized by the Tax Equity and Fiscal Responsibility Act of 1982, the benefit was meant to improve the dying experience for terminally ill beneficiaries and to reduce the intensity and cost of health care services at the end of life. After a slow start, hospice became an integral part of Medicare, and nearly half of all people who die while covered by Medicare now use the benefit before death.
Court: You Can Appeal Medicare Decisions About Hospice Services
That’s a victory of sorts, because it makes it clear that beneficiaries have the right to challenge a hospice provider’s refusal to provide a service that a doctor deems necessary, Mr. Deford said. But it’s disappointing because it doesn’t ensure that people receive a notice of their right to appeal when they enter hospice care, or that any mechanism exists for expedited appeals – an important protection for people who are dying.
Understanding the Medicare hospice benefit
While attending a national hospice conference a few years back, I recall listening to Mary Labyak, one of the earliest pioneers of hospice care in our country. I’d heard Mary speak previously and, although I never had the honor of knowing her, she was a mentor for me throughout my career. Mary stated, “When you’ve seen one hospice, you’ve seen one hospice.” I was puzzled for a moment but quickly understood—and she was certainly correct in her declaration. Hospices across the country were continuing to find new and innovative ways to deliver services, developing programs that meet the unique needs of their communities. One is as different as the next. Some hospices are small, focused on providing care within a small geographic area, while others are large with a nationwide reach. Some service urban environments while others meet the challenges of servicing rural communities. Some are not-for-profit providers, some are for-profit, and others are government sponsored. It can be a challenge to navigate through the array of programs that may be available to you, and for this I refer you to my prior blog “Choosing a hospice: Finding the right program for you and your loved one.”
Appeal Rights Confirmed for Medicare Hospice Beneficiaries in Case Brought By Center for Medicare Advocacy
Circuit Court of Appeals today also confirmed that Medicare hospice patients have the right to appeal denials of services. The defendant, Secretary of Health and Human Services Kathleen Sebelius, acknowledged after this lawsuit was filed, that Medicare hospice beneficiaries have a right to appeal coverage denials. However, the plaintiff, Howard Back could not know that, or access the appeal system, since he was told otherwise at every attempt to appeal. The 9