Seema Verma Goes to Washington

Seema Verma, the designee for Administrator of the Centers for Medicare and Medicaid Services (CMS), appeared before the Senate Finance Committee yesterday for her confirmation hearing (watch HAN’s What to Expect in 2017 video for more information about Verma!). Like most confirmation hearings, topics were wide-ranging, from electronic health records, Medicare Advantage, to rural and critical access hospital issues.

Verma’s answers, as is the case for most nominees during confirmation hearings, were somewhat vague. Nominees do not want to be pinned to specific policy options until they can find their new offices. It was clear that the contractor who engineered Healthy Indiana 2.0, Indiana’s Medicaid expansion plan, was more comfortable discussing Medicaid topics than Medicare. Several Medicare policy areas she did speak strongly about were preventing fraud and abusing being a “top priority” for the Medicare program, that she does not support turning Medicare into a voucher program, and including rural providers in the development of policies and regulations. Throughout the hearing, Verma repeated several themes that define her philosophy of healthcare policy that would carry over to her role leading CMS:

“Patients and their doctors should be making decisions about their health care, not the federal government.”

“I will work with the CMS team to ensure that the programs are focused on achieving positive outcomes and to improve the health of the people we serve.”

“I will work toward policies that foster patient-centered care approaches that increase competition, quality, and access while driving down costs.”

We’ll keep you posted on Verma’s progress through her nomination!

New CMS Memo on Hospice and Part D

Originally posted on

On November 15, 2016, the Centers for Medicare and Medicaid Services issued a new communication and analysis on the interface of Part D and hospice.

The new memorandum on Part D and the interface with hospice is based on the Office of Inspector General report where hospices inappropriately billed for GIP care (published in March 2016).  The report also identified instances where drugs were paid for by Part D, when in many cases they should have been covered under the Part A.On the positive side, CMS reported that there was a 75 percent drop in medications paid by Part D after the hospice election for drugs in the four classes:  – analgesics, anti-nausea, laxatives, and anti-anxiety drugs.  However, the memo outlines concerns for the notification of eligibility process, where hospices are not responsive to Part D sponsors in their requests for recoupment, and there is a lag in information on hospice enrollment to the Part D sponsor.

Read the CMS memorandum.

NHPCO members will find a Regulatory Alert that examines some of the specific points in the new document from CMS.


Your Latest Hospice News Update is Ready!


Happy National Hospice and Palliative Care Month! We are happy to kick off a month-long awareness campaign about hospice and palliative care with our monthly news update!

For additional resources, shareable content, and more, check out NHPCO’s National Hospice and Palliative Care Month page! Don’t forget to share the link to the Know Your Options Tool and share the newest Moments of Life Video, Lyle’s Hawaiian Dream. 

News from the Hill:

Hospice Advocates Stave Off MA Carve-In, For Now

Regulatory Update:

  1. 1. NHPCO Meets with CMS to talk NOE/NOTR
  2. NHPCO Podcast: OIG Report on Election Statements and Certification
  3. NHPCO Podcast: The Non-Discrimmination in Health Programs Final Rule
  4. 4. New CMS Data Visualization Tool Available

Advocacy Shout-Out:

Samaritan Healthcare and Hospice hosts Congressman Donald Norcross for a sneak peak of their new Samaritan Center at Voorhees

Good Reads:

  1. French Hospital Adds Wine Bar for Terminally Ill Patients
  2. A Dance for Gloria
  3. The Role of Nurse Practitioners in POLST Form Completion
  4. Facts About Hospice Care (A great article to share for #HospiceMonth!)
  5. Home Based Palliative Care Better, Less Costly than Hospitalization (Another good share for #HospiceMonth!)

A Look Ahead:

  1. Join us Friday, November 4 for Social Media Day! 
  2. Election Day is Tuesday, November 8
  3. Veterans Day is November 11. Make sure you invite your Members of Congress to any Veterans Day or National Hospice and Palliative Care Month Activities!
  4. National Rural Health Day is Novemeber 17. This is a great day to share stories about providing care in rural areas!

We Honor Veterans is now on Twitter @WeHonorVeterans. Follow them to learn more about the great work their partners do for our Veterans!

Shout out to everyone attending the NHPCO Intensives down in Florida! Thank you to Ron Culberson and BJ Miller for providing our keynote addresses. You can follow along on social media using #Intensives16.

Don’t forget to join the #hpm community each Wednesday night at 9pm ET/6pm PT to chat about all things hospice, palliative, end-of-life, etc! Patients, families, clinical staff, friends, supporters, curious onlookers all welcome! Just use #hpm on Twitter to join the conversation!

We hope you have a lovely National Hospice and Palliative Care Month, and please let us know about any events or initiatives you have going on this month! Make sure to use #HospiceMonth, #HospiceAwareness and #hpm on your Facebook and Twitter posts! And as always, you can follow us on Facebook, Twitter, and on our blog!

New NHPCO Podcast Episode: The Non-Discrimination in Health Programs Final Rule

How do you currently serve patients with Limited English Proficiency? Do you know the top 15 languages in your state? Do you have a plan to meet the new requirements of the nondiscrimination in health programs regulation? A provision of the Affordable Care Act outlines what hospice providers need to do, above and beyond what they have in place, to be compliant. This Medicare regulation, that came out of HHS/OCR with little fanfare is taking many in the provider community by surprise. It went into effect on October 16- and it is not optional.

Listen here! The NHPCO podcast is also available on ITunes.


New CMS Resource for Information on Payments and Utilization



CMS has released a new data set, the Hospice Utilization and Payment Public Use File (Hospice PUF), which provides information on services provided to Medicare beneficiaries by hospice providers. CMS also released an update to the Market Saturation and Utilization Data Tool that includes information on hospice for the first time. The Hospice PUF contains information on utilization, payments, submitted charges, diagnoses, and hospice beneficiary demographics organized by provider and state for calendar year 2014. The Market Saturation and Utilization Data Tool offers an interactive map and can be used to ascertain service utilization related to the number of providers servicing a geographic region. The Hospice PUF,the Market Saturation Tool, and a Fact Sheet are available on the Medicare Provider Utilization and Payment Data section of the CMS website.