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Healing & Comfort – Understanding the HOSPICE Act

These days in Washington, DC., the word “bipartisan” is one that does not get tossed around much. Political strife is pervasive as Republicans, Democrats and anyone else have routinely failed to compromise on a whole host of issues ranging from economic policy to immigration to practically anything under the sun. However, in a recent rare event of bipartisan compromise, the United State Congress has put forth legislation that would increase the watchdog effort specifically over hospice facilities across the country.

The legislation’s aim is to improve transparency and accountability for these facilities, and consequently improve quality of care. According to a Forbes article covering the legislation, which is backed by both House Republicans and House Democrats, the new law is also supported by the hospice care industry. Hospices so far have been subject to government recertification every six to eight years. The new legislation, the “Hospice Act,” now upgrades that process to every three years and calls for more frequent and consistent hospice surveys, while setting aside $25 million to fund these new efforts. If passed, it would ensure greater consistency of visits and thus more eyes on the performances of hospices. The bill was introduced August 1st and is known as H.R. 5393.

Addressing a Problem?

As reported, the legislation comes on the heels of criticism of the industry and other groups and agencies, including a U.S. Department of Health and Human Services Office of the Inspector General Report which revealed that the government did not consistently inspect hospices to ensure they operated up to the standards of regulations. This means that the government failed to discover poor quality of care and rules violations by too many hospices. The HHS-OIG report indicated that more than a quarter of hospices were not recertified within the last six years. Specifically, 17% of state-surveyed hospices were not recertified between roughly 2007 and 2013, which the report deemed “not an improvement” from a 14% rate based on data in taken in 2005. The inconsistency of the government’s surveying of hospices across the country led to these problems.

The U.S. Department of Health and Human Services of course takes interest in these matters particularly because it has jurisdiction over health care providers that receive federal funding through programs like Medicare and Medicaid. In fact, according to the HHS-OIG report, Medicare covered 84% of reimbursements for hospice services specifically across the country in the year 2011. And between 2005 and 2011, hospices received a significant increase in payments from Medicare at $13.8 billion, up from $8.2 billion 6 years earlier. Thus with so much government money going to these providers, it is vital for HHS and CMS (Centers for Medicare and Medicaid Services) to ensure such providers are following rules and regulations and providing proper quality of care to hospice patients. The report made specific recommendations, including more frequent and consistent visits and the shorter three year recertification period.

Having a loved one in hospice care can be such an upsetting and emotional time. It is vital that patients in hospice receive the utmost quality of care so that they may live out their final days as comfortable as possible. This includes attentive care and high quality care along with the compassion commensurate with the situation. With more frequent visits should hopefully come more accountability, and as hospices stay up to code, they will have no problem gaining recertification and continuing to collect federal dollars while providing the proper care for their patients.

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