A change coming for hospice?

Ed1937

I received an email a few days ago that mentioned this possibility. Apparently there has been quite a lot of fraud from hospice providers. It mentioned that "for profit" hospice companies are much more likely to commit fraud than "non profits". The matter is bad enough that it is being discussed in Congress, and changes may be coming. It said that hospice generates high profit, and there are so many new companies trying to get into hospice that the growth of new companies outweighs the demand for them. It mentioned that the "bad actors" bring in patients way earlier than they should, and people remain in hospice for much longer periods of time. Let's hope they don't get too strict on that.

Tony484

Ed,

For lack of knowing a better place to put this and not wanting to start an "Ed Thread", thanks for all that you do for us on this site, both individually and collectively, over the year.  Happy New Year.

M1

Second that, and third and fourth.  Thinking of you today Ed, six months since you so suddenly lost Carol?  Seven?

Jo C.

This was also  an "issue" in the not so distant past some years back with a high degree of government involvement.  Some Hospices tried to game the system to maximize profit and it had quite a significant impact, but it certainly was not all of them.  Bad actors caused negative impact for the good ones. To address this, federal mandates were set into place  AND the auditing of Hospice services, billings, and actual patient records became stringent along with harsher criteria and rules for services.  Audits of Hospice patients records are robust and ongoing.  This situation led to and leads to denials of payment to Hospices even on many valid patients and it also made changes in the reimbursement system; not to Hospice advantage.  It was about the admissions. . . . and continued service . . . some of it was sometimes so egregrious in denials of necessary services it was difficult to fathom.  Patients were affected.   The demand for reams and reams of paperwork became  required for Hospices.  Documentation is everything.  This is why the written intake process is so lengthy and deeply detailed as required.

What  began to become evident in the jumble of this was that there were patients who should have been on Hospice or who should remain on Hospice and they were not able to do so.  This takes a huge toll on people and especially persons with dementia; just look at the criteria for admission to Hospice under the diagnosis of dementia.   Good luck on that.  Many persons with dementia are admitted to Hospice with a diagnosis of other medical conditions such as COPD, or CHF, etc.  Still strong criteria present but not as harshly eliminating as for the diagnosis of dementia. 

It has long been true that one of the major groups at disadvantage of support in the big D.C. are the elderly.  Not a major political group as  a voting bloc; so the elderly are more or less an after thought or even swiped aside or there is alway discussion about cutting services or cutting payments, etc.  Disabilities are also compromised in various ways.   The elderly do not make noise as a huge group and huge group loud noise on national news gains attention and is responded to.

Will have to see what this leads to or doesn't lead to depending on what comes up.

J.

Ed1937

Tony, thank you. Happy New Year to you.

Ed1937

M1. Yes, it is 6 months today since Carole passed. So far I've made it through Thanksgiving and her birthday without too much trouble. Next Wednesday will be our anniversary. I don't know what to expect.

Dio

Ed1937 wrote:

M1. Yes, it is 6 months today since Carole passed. So far I've made it through Thanksgiving and her birthday without too much trouble. Next Wednesday will be our anniversary. I don't know what to expect.

Wishing you strength with fond memories! You'll get through it, as you've helped us.

Joydean

I also want to say thank you Mr Ed for all have done and continue to do for all of us! You are truly a blessing.