Friday, May 6, 2011

Advocacy Group on New Medicare Hospice Law: “An Issue that Must be Closely Watched”

Hospice is “a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments, explains the Hospice Foundation of America.

For families with a loved one currently receiving Hospice care, a new law is under debate and analysis by some advocacy groups. At the very least, they are keeping a close watch on the real-world effect of the law.

The new Medicare Home Health Face-to-Face Requirement is a condition of receiving payment for hospice services. “A physician must order Medicare home health services and must certify a patient’s eligibility for the benefit,” according to Center for Medicare and Medicaid Services (CMS). Moreover, “[before certifying] a patient’s eligibility for the home health benefit . . . [he or she] . . . must document . . . a face-to-face encounter with the patient.”

Why did Congress enact this law? Will the administrative burdens be worthy of debate? The rationale appears to have been; “[to ensure] that the orders and certification for home health services are based on a physician’s current knowledge of the patient’s clinical condition.” What remains unclear is whether Congress is trying to prevent some sort of perceived abuse of the Hospice process, whether Congress perceived physicians as lacking in diligence in this regard, or if it is a means to ensure money is not wasted.

Some groups ARE raising questions. For example, an article recently was published by CMS, entitled, “New Hospice Face-to-Face Requirement: Help or Hindrance? The group expresses hope that the law will encourage more physician involvement, but also concern that “caring for hospice patients in their third and subsequent certification periods . . . [might become more] . . . difficult and potentially more expensive for providers than caring for patients in their first and second certification periods.” The group ends its article by noting it will continue to watch the issue, so that Medicare beneficiaries who are nearing the end of their lives will not bear any unintended burdens or care shortcomings as a result of this new law.

Image: Sura Nualpradid /

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