Home Health & Hospice Week

After a series of high-profile, extremely critical articles about some hospices’ practices in The Washington Post, The Wall Street Journal, and other press outlets, Congress has passed a law aimed at combatting fraud and abuse in the hospice Medi-care benefit. The House and Senate have approved the Improving Medicare Post-Acute Care Transfor-mation (IMPACT) Act, and President Obama is expected to sign it into law soon. 

Many in the industry applaud the legislation’s requirement that hospices undergo Medicare surveys every three years. It also allows for medical review of hospices with a high proportion of long-stay patients.

“This will bring hospices up to the standards of the health-care industry,” Christy Whit-ney, chief executive of HopeWest hospice in Colorado, told the Post. “I really believe that a lot of the issues that have been exposed can be prevented by this. It won’t just catch bad actors. It will make well-intended hospices better, too.”

Bad news: The feds will pay for the increased surveys by taking the money out of hospice caps. “While we predict that the change in the calculation of the hospice cap update will not impact most hospices, it is expected to slow the rate of growth in the hospice cap,” notes the National Association for Home Care & Hospice. That “may mean that, over time, more providers exceed the cap or that those exceeding the cap do so by a higher amount than would otherwise be the case,” the trade group says.

In an analysis of recent years’ caps, the change would have reduced the cap update by amounts ranging from 0.13 to 1.48 percentage points, NAHC found. “This will provide a strong incentive for those hospices with cap-related overpayments to review their admission/discharge criteria,” NAHC says.