New Medicare hospice rules aim to boost physicians' role

The most significant changes are designed to give patients more rights.

By David Glendinning, AMNews staff. July 14, 2008.

Washington -- Medicare, for the first time in 25 years, has updated the rules for hospice physicians.

The Centers for Medicare & Medicaid Services in June released final conditions of participation for hospice professionals. The new guidelines, the only overhaul of the regulations since Medicare first offered the benefit in 1983, will take effect on Dec. 2.

Some of the most significant changes are in the area of patient rights. The document states that patients who choose palliative care over curative treatments have the right to participate in developing their treatment plans. This includes access to effective pain medications, the ability to choose one's own physician and the option to refuse treatment.

Upon choosing the hospice benefit, patients must receive initial medical assessments within 48 hours and comprehensive evaluations within five days. Assessments must be updated at each 15-day interval after that. Currently, there are no rules detailing when these reviews must be done. Hospice patients also must receive full medication profiles for their conditions.

CMS officials decided to update the participation rules because increasing numbers of Medicare patients are choosing hospice. Nearly 1 million Medicare beneficiaries receive hospice care from more than 3,000 hospices in the U.S.

"End-of-life care has changed markedly in the past 25 years, and it is time to update our regulations to reflect advances in medicine and hospice industry practices, as well as patient rights," said Kerry Weems, acting CMS administrator.