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Hospice & Part D

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by

Lauren Drew

on 10 December 2013

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Transcript of Hospice & Part D

Hospice Action Network
Hospice & Part D:
a primer

Our mission is to advocate, with one voice, for policies that ensure the best care for patients and families facing the end of life.
History & Definitions
When a patient becomes eligible for hospice, the hospice provides all of the care related to the terminal condition.
When a patient becomes eligible for hospice, the hospice provides all of the care
related to the

terminal condition.
An example: Jane
Alzheimers' Disease
No pain medications prescribed
Broken tooth: Medicare Part D Provides Percocet
HAN's Policy Points
Medications unrelated to terminal condition= Medicare Part D
Rx
Recent Developments
Mistakes made- double billing
Study of the overlap between Hospice & Part D
CMS' Confusing Actions
Part D Plans directed to recoup ALL payments for pain meds given to hospice patients in 2011-2012
Hospice now has to pay for pain meds for Jane's tooth (Alzheimer's patient).
Additional (troubling) guidance
Why does this matter?
1) A dangerous precedent- what's next?
2) Fundamentally changing the Medicare Hospice Benefit without public debate.
Hospices should
absolutely
pay for all care related to terminal condition.
Real world implications:
Pharmacies refusing to dispense
Referrals down
Rx
Let's take ACTION!
Sign-on Letter
Click below to write your Member of Congress.
Have a good relationship? Time to use it!
OIG recommended stakeholder education & oversight
Affirmed recoupment directive
'Prior Authorization'- good idea, but short on details.
'VIRTUALLY ALL' medications responsibility of hospice, 'VERY RARE' that Part D should pay.
This simply isn't the clinical reality!
Full transcript