Medicare Rights for Hospice Patients Outlined

Individuals with terminal illnesses have the right to choose their end-of-life care.  That has long been an issue that has received attention from individuals, families, the public, hospitals, insurance companies and more.

The Center for Medicare and Medicaid Services (CMS) has now put this information in writing, including it in the outline of a new regulation regarding this issue.  CMS will publish and release the outline later this year.

Previously, there was no specific language regarding individual patient’s rights in regulations.  This new regulation is the first update since 1983, when Hospice care and end-of-life rights were not as wide an issue as they have become now.

Many Hospice patients are already very involved in their rights, care and treatment, as well as their wishes as they come to the end of their life, however, now that there is a specific regulation with language in place which details and reinforces those rights, there is stronger protection for those who might want to explain their wishes but need the support to do so.

Some of the rights of individuals involved in Hospice care or palliative care include participation in their treatment plan, the right to effective pain management, the right to refuse treatment and the right to choose their own physician.

Hospice care can be chosen when a patient decides that curative care is no longer an option for them.  By choosing Hospice care, they are choosing to receive care that will provide comfort and care to themselves and sometimes to the family members, as well.  This type of care can be provided at home as well as in an inpatient setting.  Nearly one million Medicare beneficiaries are receiving Hospice care at any given time.

Updating the regulation and reinforcing patients rights – on paper – is an important step in making sure that the individuals who are making decisions about end-of-life issues do not have to struggle with the emotional issues involving deciding on care and receiving support.

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Hospice and Medicare – At Odds?

Hospice has come to be synonymous with helping people at the end of their lives die with dignity.  It is not an easy situation.  It is difficult for the patient, difficult for the family and difficult for the hospice provider. 

The majority of hospice providers are caring people who extend themselves to patients and their families at the worst time imaginable.  Since illness at the end of one’s life is not an exact science, even patients who would seem to have weeks or months to live can defy the odds and live much longer.  This is, of course, a very positive situation for many families, as long as the patient is not suffering.

As if all of this is not enough, picture payment issues with Medicare.  For instance, imagine a hospice that is providing care for a number of people – patients who have lived longer than Medicare will pay.  What should a provider do?  Stop taking care of these patients?  Once the hospice has obtained the allotted number of extensions and is out of funding, what should they do with the patient that is still holding on to life?

This is a question that has been taken to Capitol Hill and is being examined carefully.  A number of hospice administrators are trying to sort out this issue.  There are some who are millions in debt to Medicare – in fact, Medicare has told them that they need to pay up or declare bankruptcy.  This is a very difficult situation for individuals to be in when they have spent their lives trying to help and care for patients and families who are suffering one of the ultimate issues humans can go through.

It will be interesting to see how this situation is solved and what happens to this most essential and delicate service that is rendered at the most vulnerable time in a family’s life.  Hopefully there will be a way to address this issue and solve this problem without compromising caregivers or the people they serve.

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