Changes in end-of-life care necessitated the overhaul The Centers for Medicare & Medicaid Services in a June 3 press release announced a new regulation that strengthens terminal patients' rights to control their hospice care. The new Medicare Conditions of Participation will affect the nearly 1 million Medicare beneficiaries receiving care from more than 3,000 Medicare-approved hospices nationwide. "As more patients and their families come to understand and select hospice care, we felt it was critical to outline what rights patients have to control the care they receive in their final days," Kerry Weems, acting administrator of CMS, says in the release. The rule outlines specific rights for patients who choose hospice or palliative care over curative treatment, the release says. These patients are entitled to participate in their treatment plan; receive effective pain management; refuse treatment; and choose their own physicians. The new regulation is the first overhaul of regulations governing the hospice industry since 1983 and is the first to set out a detailed list of patient rights. The final regulation also includes provisions for assessing patients and monitoring their drug therapies, the release says. And a new provision allows a hospice to "contract with another Medicare-certified hospice for nursing, medical social services, and counseling services under extraordinary or other nonroutine circumstances." The regulation is online at http://www.cms.hhs.gov/CFCsAndCoPs/05_Hospice.asp.