Home Health & Hospice Week

While it's vital to know when to give out required hospice advance beneficiary notices under the new rules, it's just as important to know when not to give them out.

Hospices that furnish unnecessary ABNs to patients risk confusing the patients and wasting time, money and energy.

The Centers for Medicare & Medicaid Services says hospice ABNs are not required in the following instances, notes attorney Ross Lanzafame with Harter Secrest & Emery in Rochester, NY.

1. Revocations. Hospice beneficiaries or their representatives can revoke the hospice benefit at any time. Revocations are not considered terminations, since the beneficiary is exercising her own freedom of choice, and no ABN is required.

2. Respite Care Beyond Five Consecutive Days. Mandatory notification is not required when respite care exceeds five consecutive days, because payment for respite care is limited to this time period. Respite care on the sixth consecutive day is therefore considered outside the definition of the hospice benefit, and the hospice provider is not required to issue an ABN.

However: CMS encourages hospice providers to give the ABN as a voluntary notice to inform patients of possible financial liability in such cases, points out the National Hospice and Palliative Care Organization in its ABN tip sheet for members.

3. Transfers. Beneficiaries are allowed one transfer to another hospice during a benefit period. However, subsequent transfers within the same benefit period are not permitted. In either case, an ABN is not required.