Senator Ron Wyden (D-OR) and Republican Tom Reed (R-NY) have introduced The Hospice Evaluation and Legitimate Payment (HELP) Act (S. 722/H.R. 3506). The National Association of Home Care & Hospice (NAHC) and the National Hospice & Palliative Care Organization (NHPCO) have requested support in contacting their State Representatives and Senators requesting their support for this Act.
The HELP Act has three components:
- Test the new Hospice payment system prior to implementation.
- Overhaul the hospice face-to-face encounter requirements
- Define the Hospice program survey requirements
Current laws indicate that payment reform will begin on or after October 1, 2013. Currently, the Centers for Medicare and Medicaid Services (CMS) are not required to test the payment reform for the purpose of identifying the impact to Hospice agencies.
Face-to-Face Encounter Requirements
Face-to-Face Encounters are required as of January 1, 2011. With the requirements, patients who are entering their third, or subsequent, benefit period must have a face-to-face encounter with a Hospice physician or nurse practitioner (NP). Under the current guidelines, Hospice agencies have up to two days to complete the face-to-face documentation if there are “exceptional circumstances.” Currently, some Hospice agencies are finding it challenging to meet the timeframes of the new face-to-face requirements. Under this Act agencies would have an additional seven days to complete the face-to-face requirements when “exceptional circumstances” exist. In addition, it would allow physician assistants to perform the face-to-face encounter.
Hospice Program Surveys
On average, Hospice agencies are surveyed every six to eight years. More frequent surveys are required as a result of the regulatory changes to ensure that agencies are meeting the new requirements. Subsequently, this Act suggests that all Hospices undergo surveys every three years. This would be in line with industry standards set forth by accrediting organizations, such as the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO).
We urge you to contact your State Senators & Representatives to ask them to support this Act.
Additional Links regarding the HELP Act found at http://www.hospiceactionnetwork.org/