As you may know, yesterday the Senate reached an agreement on a package of budget and Medicare bills known as the Medicare Extenders. The legislation is expected to pass both the Senate and the House and be signed by President Trump later this week. The bill included several provisions of interest to the hospice community.
The great news is that the legislation includes The Medicare Patient Access to Hospice Act, which would allow physician assistants (PAs) to serve as the attending physician to hospice patients and perform other functions that are otherwise consistent with their scope of practice. Currently, Medicare only allows physicians and nurse practitioners to serve as the hospice attending physician, despite the fact that there is a shortage of hospice providers in rural and underserved communities. Often times, people in these communities receive primary care from a PA prior to their hospice election and must give up that provider when they elect hospice. This common sense, bipartisan legislation will go a long way to ensuring that patients can have their preferred care team at the end of life. NHPCO strongly supported this important legislation and applauds Congress for its inclusion in the Medicare/budget package.
Another positive development is a requirement for the General Accountability Office to study and report on longitudinal comprehensive care planning services under Medicare Part B. This study – due 18 months after enactment – could help inform the development of a payment code describing the formulation of a comprehensive plan of longitudinal care for a Medicare beneficiary diagnosed with a serious or life-threatening illness.
The legislation also includes a provision that reduces payments to hospitals upon transfer to hospice. NHPCO closely monitored this legislation, as there is some concern that hospitals could delay hospice referral to recoup their entire DRG patient. To better assess the overall impact, Congress also mandated that the Medicare Payment Advisory Committee (MedPAC) evaluate this change to determine its effect on hospital-hospice transfers, hospice length of stay, and overall spending. The budget deal did not include the Rural Access to Hospice Act, but NHPCO will continue to push for enactment of that bill later this year.
So as we continue to push for support of the Rural Access to Hospice Act, let’s also take a moment to celebrate this phenomenal victory for the hospice community and share the news with our constituents!
As usual, we will continue to keep you updated on any legislative changes and we need YOU to continue to advocate for quality, end of life care.