Hospice Reforms Signed into Law, By Jondi Gumz

COMMUNITY NEWS Hospice Reforms Signed into Law

By Jondi Gumz

The Helping Our Senior Population in Comfort Environments (HOSPICE) Act, introduced Feb. 10 by U.S. Rep. Jimmy Panetta (D-Carmel Valley) and U.S. Rep. Tom Reed (R-New York) is now law.

This legislation mandates oversight and transparency of Medicare hospice providers.

It was passed by the House unanimously as part of the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act. Then the BENES Act was folded into the FY2021 Omnibus Appropriations Bill, which was signed by the president on Dec. 22.

“Most hospice facilities provide compassionate care to patients and families, but there are some that fail to rise to the standards those in their care deserve,” said Panetta. “Our legislation increases transparency and accountability to support the safety and wellbeing of hospice caregivers and those in their care.”

In July 2019, the Department of Health and Human Services Office of Inspector General released two reports that identified significant deficiencies in the quality of care for Medicare hospice enrollees.

According to the two reports, 87 percent of hospices had at least one care deficiency between 2012 and 2016.

Twenty percent had at least one serious deficiency, meaning that the health and safety of a beneficiary were in jeopardy.

Based on 50 reports of serious deficiencies, the Inspector General found 12 cases where Medicare beneficiaries were seriously harmed. One individual with Alzheimer’s developed gangrene and had the lower leg amputated after the hospice did not treat pressure ulcers on the heels. Another hospice allowed maggots to develop around a man’s feeding tube while under care at home.

In other instances, the hospice failed to recognize signs of sexual assault of a woman at an assisted living facility, did not intervene when a man caring for his father at home would not help him up and would not clean his dirty briefs, and did nothing when a man living in an apartment had his medications for pain and anxiety stolen by a neighbor who came in naked and unannounced – even though hospice employees were aware of that situation.

Of these 12 cases, only one hospice reported the harm to Medicare.

The reports did not name hospice program operators where Medicare beneficiaries were seriously harmed.

In 2017, Medicare spent $17.8 billion for hospice care for nearly 1.5 million beneficiaries, up from $9.2 billion for fewer than 1 million beneficiaries in 2006 but had only one remedy to penalize a poor performing hospice: Removal from the Medicare program.

The Office of Inspector General issued a series of recommendations to improve quality in hospice care, many of which are addressed in this bill.

The law, funded with $10 million, will require surveys of hospice programs every two years starting Oct. 1, and the results are to be published, in a searchable manner, on the Medicare.gov website starting Oct. 1, 2022.

Trained multidisciplinary teams are to conduct the surveys.

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