The nation’s four leading hospice provider organizations aired concerns about the rapid growth and integrity of the nation’s hospice program earlier this week with Centers for Medicare & Medicaid Services Administrator Chaquita Brooks-LaSure.
LeadingAge, the National Association for Home Care & Hospice, the National Hospice and Palliative Care Organization and the National Partnership for Healthcare and Hospice Innovation told Brooks-LaSure additional oversight is needed for bad actors in the segment and to ensure that Medicare beneficiaries receive quality of care at the end of life.
Last month, the four groups jointly sent a list of 34 recommendations to CMS to improve the hospice program. The recommendations included limiting new providers with a targeted moratorium on new hospices; take more stringent enforcement action against providers that show aberrant gaps in Medicare billing; develop a “red flag” criteria that would prompt an immediate CMS investigation regarding noncompliance; require surveyors to confirm ability of hospices to provide all four levels of care; and add hospice administrator and patient care manager qualifications to Medicare hospice Conditions of Participation.
“We drafted these proposals, which include both big ideas as well as actionable fixes, with one goal: to make the hospice benefit work better, and to ensure it remains a sustainable and noteworthy benefit,” LeadingAge President and CEO Katie Smith Sloan said in a statement.
Hospice programs have come under scrutiny in recent years due to an explosion of hospice programs across the country. Stemming from the Hospice Act of 2020, CMS launched new guidance for hospice surveyors at the end of January. The guidance requires surveyors to review all the quality metrics available on Care Compare and also include press reports as part of background information on hospices.
Prompting the inclusion of press reports was an investigative article by the media site ProPublica last fall. The article accused some hospice providers of recruiting some patients who were not near death and dumping others who had long hospice stays.
Suggestions to improve the hospice benefit
Separately, LeadingAge recently released hospice benefit reform ideas to Congress. The ideas include: allowing concurrent palliative care with guardrails; making palliative care financial viable under Medicare Part B; and adding two new hospice levels of care.
“We drafted these proposals, which include both big ideas as well as actionable fixes, with one goal: to make the hospice benefit work better, and to ensure it remains a sustainable and noteworthy benefit,” LeadingAge President and CEO Katie Smith Sloan said in a statement. “The most common comment our hospice members hear from patients and families is ‘why didn’t I get your services sooner?’ Additions, including new levels of care and providing hospices with sufficient resources to pay for treatments that have a palliative intent but are, currently, cost-prohibitive, would greatly increase access and utilization of the current benefit, thereby addressing this concern.”
