Advocacy Round-Up!

Wow! Things have been busy in the realm of hospice and palliative care advocacy this past week. From having over 350 constituent meetings held in Congressional offices to many calls made by those participating in Virtual Hill Week, hospice and palliative care advocates are being heard all over Congress. And their hard work is paying off!

Here are some pictures of our front-line advocates attending Congressional meetings during their brief visit to Washington D.C.


Since July 17th, the following Members of Congress co-sponsored HAN-supported legislation:

The Patient Choice and Quality Care Act:

  • Rep. André Carson [D-IN7]
  • Rep. Jimmy Duncan [R-TN2]
  • Rep. Jamie Raskin [D-MD8]
  • Rep. David Young [R-IA3]
  • Rep. Carol Shea-Porter [D-1]

The Rural Access to Hospice Act:

  • Rep. Jimmy Duncan [R-TN2]
  • Rep. Matt Gaetz [R-FL1]
  • Rep. Patrick Meehan [R-PA7]
  • Rep. Kristi Noem [R-SD0]
  • Rep. Jamie Raskin [D-MD8]
  • Rep. David Young [R-IA3]
  • Rep. Carol Shea-Porter [D-1]


  • Sen. Patrick Leahy [D-VT]
  • Sen. Bernie Sanders [I-VT]

The Palliative Care and Hospice Education Training Act (PCHETA):

  • Sen. John Boozman [R-AR]
  • Sen. Kirsten Gilibrand [D-NY]
  • Rep. Judy Chu [D-CA27]
  • Rep. Lacy Clay [D-MO1]
  • Rep. John Conyers [D-MI13]
  • Rep. Carlos Curbelo [R-FL26]
  • Rep. Ann Kuster [D-NH2]
  • Rep. Dan Newhouse [R-WA4]
  • Rep. Richard Nolan [D-MN8]
  • Rep. Bill Pascrell [D-NJ9]
  • Rep. Ed Perlmutter [D-CO7]
  • Rep. Mike Quigley [D-IL5]
  • Rep. Lucille Roybal-Allard [D-CA40]
  • Rep. Thomas Suozzi [D-NY3]
  • Rep. Niki Tsongas [D-MA3]
  • Rep. Peter Visclosky [D-IN1]


To keep up this wonderful uptick in advocacy, please take a moment to e-mail your Members of Congress NOW by clicking on one of the following action alerts below:

Patient Choice and Quality Care Act Action Alert
Rural Access to Hospice Act Action Alert

Otherwise, you can call Congress too through our Virtual Hill Week module! Please keep up the good work!

Sneak Peek: Advocacy Intensive 2017

Be the voice of your patients and families on Capitol Hill.

The 2017 Hospice Action Network Advocacy Intensive is your best opportunity for the hospice community to speak with one voice with the policy makers who craft legislation that impacts the hospice and palliative care community. On July 17, we will prepare you with the skills and information you will need to educate new and returning Members of Congress about the priorities of the hospice community.

Here’s a sneak peek at some of the offerings we’re planning:

State of Play on Capitol Hill

Participate in a discussion with bipartisan panel of lobbying experts on what is going on here in Washington. We’ll walk you through what Congress is working (or not working) on while you’re here, and what’s likely to be on the mind of your Member of Congress or their staff when you meet with them on July 18.

How to Speak “Congress”

Ever wonder what makes the other political party tick? In this session, learn how to tailor your message to effectively communicate to Republicans and Democrats. Whether your Members of Congress are “fiscal conservatives” or “progressive liberal,” you will come away from this session able to speak to their concerns, regardless of political party, to garner support for our asks.

From Constituent to Influencer – Cultivating Strong, Meaningful Relationships with Elected Officials

Advocacy is not a once-a-year event. If you want to be more than a constituent in a crowd and if you want to have real influence with elected officials, you have to build a culture of advocacy that permeates your entire organization. During this session, faculty will discuss time-tested approaches to building strong, beneficial relationships with elected officials. Hear real-world examples from hospices that have built and sustained relationships with elected officials through site-visits, We Honor Veterans ceremonies, employee and volunteer engagement, social media campaigns, and more.

But it’s not all work. We do let you have a little fun. Just at this group!

 Questions? Email us!

Can’t wait to attend?


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.


OIG Releases Report on Election Statements and Certifications of Terminal Illness

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The Inspector General of the Department of Health and Human Services (OIG) released a report on September 15, 2016 entitled Hospices Should Improve Their Election Statements and Certifications of Terminal Illness.” This report focused on findings in two areas – election statements and physician certification and attestation. OIG’s report highlights several examples where hospices were imprecise or overly-general in their hospice election paperwork and fell short when filing their physician narratives. It makes four recommendations to CMS to rectify these deficiencies:

  1. Develop and disseminate model text for election statements
  2. Instruct surveyors to strengthen their review of election statements and certifications of terminal illness
  3. Educate hospices about election statements and certifications of terminal illness
  4. Provide guidance to hospices regarding the effects on beneficiaries when they revoke their election and when they are discharged from hospice care

NHPCO Members can access a detailed analysis of this report here: OIG REPORT

Text from NHPCO’s Official Press Release on the Report is below:

For Immediate Release:
September 15, 2016

NHPCO Responds to New Report from OIG on Hospice

(Alexandria, Va) – Today, the Department of Health and Human Services Office of the Inspector General (OIG) released a report on hospice care that focused on findings in two areas: election statements, and physician certification and attestation.

The OIG’s attention was anticipated and NHPCO’s Health Policy Team has done an initial assessment of the report findings – as is customary – and will use this information to inform our advocacy strategy and add to our existing regulatory resources and educational materials that promote the delivery of high quality care to individuals who are medically eligible to receive hospice services.

NHPCO shares OIG’s belief that hospices must provide complete and accurate information in election statements so that beneficiaries and their caregivers can make informed choices.

Hospice organizations typically employ a very robust intake process that involves multiple conversations and interactions between the hospice team, patients and their caregivers. While these conversations and interactions are generally very thorough, the OIG’s report highlights several examples where hospices were imprecise or overly-general in their hospice election paperwork and fell short when filing their physician narratives.

For example, 20 percent of hospice elections in the sample failed to specify that beneficiaries were electing the *Medicare* hospice benefit (as opposed to a managed care or Medicaid benefit). Others were too general in their statements, suggesting, for example, that beneficiaries waive *all* other Medicare benefits.  In fact, hospice patients can continue to access Medicare benefits for conditions unrelated to their terminal illness.

“It is important to note that OIG found that some inconsistencies might stem from discrepancies between hospice statute, regulations and the CMS manual,” said Jonathan Keyserling, NHPCO senior vice president for health policy.

NHPCO agrees with OIG’s common-sense recommendations to CMS to address these issues. In fact, NHPCO recently worked with one Medicare Administrative Contractor on model text for election statements, and provides training and assistance to our members to ensure that their election processes, physician practices and administrative functions are compliant with CMS regulations.

Preceding the release of the report by the OIG, an article published by The Washington Post, “How tens of thousands of patients who weren’t actually dying wound up on hospice care,” uses information from the OIG report and makes some broad-based conclusions that inaccurately imply gross levels of fraud. While media attention on issues of compliance in the field is understandable, NHPCO is concerned that patients and families who might see this article might be frightened by the sensationalized headline.

NHPCO members will find a Regulatory Alert available online.  In addition, NHPCO has a detailed compliance guide on the hospice election process that is available online for members.


To speak with a member of NHPCO’s Health Policy Team, please contact:
Jon Radulovic
Vice President, Communications
Ph: 703-837-3139



Have you asked your Members of Congress to attend our #BeingMortal event?

Just a quick reminder that our Congressional Screening of Being Mortal, featuring Dr. Atul Gawande, CMS Chief Medical Officer Patrick Conway, and musician and family caregiver Rory Feek is next Wednesday, June 22 at 5:30pm in Dirksen Senate Office Building 106. Have you asked your Members of Congress to attend? You can do so here!

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We are also thrilled to have Senator Mark Warner (D-VA) and Senator Susan Collins (R-ME) making opening remarks. They are joined by Congressman Phil Roe (R-TN), Congressman Earl Blumenauer (D-OR) and Congressman Tom Reed (R-NY), who will also speak about their experience working to improve end-of-life care in America. We are excited to have such strong bipartisan support!

I know many of you have already contacted your Members of Congress to request that they and/or their staff attend this event, and thank you for doing that! If you haven’t reached out yet and would like to, please use this link:


Thank you all for your help getting the word out! We are also planning on recording the event, so stay tuned for how to get a copy!