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On April 4, 2011, Sen. Ron Wyden (D-OR) and Pat Roberts (R-KS) introduced the Hospice Evaluation and Legitimate Payment (HELP) Act (S. 722), a bipartisan bill that would establish 15 hospice pilot sites to test a new payment system beginning October 13. The Affordable Care Act mandates that the hospice payment system be reformed by 2014, and the pilot sites would make sure that the new payment system will not have an adverse impact on hospice care. “With changes to the hospice Medicare reimbursement formula on the horizon, we need to make sure that hospice facilities can continue to accept Medicare patients,” Wyden said in a press release. “This bill tests any and all changes to the new system to make sure they are not negatively affecting the hospice programs that many terminal patients and their families rely on in their final days.”
The Wyden bill amends the requirements that all hospice patients meet face-to-face with a doctor before admission to a hospice. The bill would allow nurse practitioners, physician assistants and others to perform the required face-to-face visit.
Finally, the bill would change the Medicare accreditation requirement by mandating a 6-month initial survey, then initiating follow-up surveys every 3 years. Currently, hospices are surveyed on average every 8 years. In some states, it is about 10 years. The lack of consistent surveys adds to existing Medicare integrity issues.