Hospice Coverage: A Case Study

Medicare beneficiaries might need to jump through some hoops to get that palliative care.

Hospice is one of the services covered for Medicare beneficiaries and is obviously a necessary service at the end of life. In the past, Hospice had four benefit periods, two-90 day periods, one-30 day period and one unlimited period. Prior to 1998, if a member entered the unlimited period but did not die, they lost all future Medicare Hospice coverage. The regulation was changed in 1998, now Hospice benefits can no longer be exhausted with new terms outlined as such, two-90 day periods of care, followed by an unlimited number of 60 day periods of care. Which sums up, that Medicare beneficiaries can live more than 210 days and no longer fear that they might not die in time and exhaust their Hospice coverage. In the past that must have been stressing on the ill person and their family, that they could be financial strapped with medical bills.

With the change in Hospice care coverage, this service has grown significantly. Unfortunately though, CMS and Congress felt that unlimited access to end of life services has once again become a financial incentive to keep beneficiaries in

So needing Hospice care on a Sunday will not work out to will for the patient, who will have to wait for Monday to get that much needed referral. In addition, providers will not even be reimbursed for their services. All though this will control costs for Medicare, it will decrease access to hospice care for Medicare beneficiaries. The new rules get even worse! If the beneficiary is discharged and has the needed to be readmitted, they may not be admitted in the active process of dying, not only that but a Hospice practitioner may not be available for a face-to-face. The thought is that with all of the documentation and need for an encounter, it will cut down on fraudulent long term