Many families and health care providers are debating whether the Centers for Medicare and Medicaid Services, which runs Medicare (CMS) and Congress are doing enough to implement processes to protect patients and their families from hospice providers who may be exploiting the service. Recently, CMS finalized a $340 Million/ 1.8 percent increase in Hospice payments for Medicare Hospice providers.
According to reports, the Office of Inspector General (OIG) at HHS synthesized 10 years of research into the Medicare Hospice Program and found many deficiencies in patient care, inappropriate billing and even fraud. The Centers for Disease Control and Prevention (CDC), has reported that hospice care involves more than 1.3 million patients and 4,000 agencies — most of them private but Hospice care in America is highly scrutinized. CMS, which runs Medicare received several recommendations from the Inspector General’s office with regard to performance of hospice providers including:
- Giving CMS the authority to hold poor performing hospices accountable and take swift action when warranted
- Model payments after a “patient care needs and quality of care” approach, and eliminate the flat rate payment system.
- Give the public /medicare beneficiaries access to a system that effectively compares Hospice providers.(currently beneficiaries can obtain a referral from Medicare or at Medicare.gov/hospicecompare)
To date many measures have been initiated and CMS has finalized new standards to help determine what measures hospices will no longer have to report under its meaningful measures initiative, also a review timeframe for data submitted using the Hospice Item Set (HIS), as well as changes to how information will be displayed on Home Health Compare according to news sources. A final rule, received with much support from the National Hospice & Palliative Care Organization (NHPCO), will see Physician assistants categorized as designated hospice attending physicians. The reimbursment and finalized rules changes will begin on Jan. 1, 2019. According to reports hospices will have a 30-day review process for the information.