Congress is currently in the process of negotiating a package of Medicare-related legislation that would cut payments to hospitals when a hospice transfer is made sooner than a Medicare-established average length of stay. The rationale for this change is that the federal government should not pay two providers (both hospitals and hospice agencies) for the same days of care. A similar restriction is currently in place for when a patient is discharged to home health, psychiatric hospitals, and other settings, so this change would put hospice in the same category as other post-acute care providers. Further, the change would save the government a significant amount of money – between $600 million and $1 billion.
NHPCO has been closely engaged on this issue since early December. We consulted with the Public Policy Committee to discuss the potential impact of this change, and many expressed concern that this could incentivize hospitals to delay hospice referral until after the patients has stayed long enough to receive the full payment, potentially resulting in shorter lengths of stay in hospice. NHPCO has conveyed these concerns to key legislative staff to determine whether Congress would consider alternative approaches that would assure patient access to hospice. These conversations are ongoing, and we hope that the final policy will address our concerns and remove any unnecessary barriers to hospice. We are also working to include the Rural Access to Hospice Act as part of the larger legislation.
All NHPCO members are encouraged to contact their members of Congress to share their concern about the proposed hospital DRG change, and to encourage them to protect hospice and include the Rural Access to Hospice Act in the Medicare extenders package. To contact Congress about this issue, visit the Our Rural Action Center.
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