Misplacing a burden on hospice Hospice programs all over the country are still breathing a sigh of relief, after proving that an organized message can work wonders. Hospices across the country received a federal guidance document earlier this year that sent them, many felt, down a dangerous road. In June, with two local workers being asked to take part, hospices organized a mission to Washington, D.C., to try and change that direction. A guidance is typically a set of instructions from a regulatory agency. In this case, it came from the Center for Medicare and Medicaid Services, also known as CMS. Linda Furman Grile, the director of South Coast Hospice in Coos Bay, says the order ended up putting an undue burden on hospice programs by forcing them to pay for extra medications that were not related to the patients terminal condition. According to documents delivered to CMS officials, in protest of the guidance, the order basically established a procedure that intended to limit instances where Medicare Part D was being forced, inappropriately, to cover prescription medications that were related to the patients terminal condition. Oregon Rep. Peter DeFazio was among the Congressmen in Washington who came to the aid of the hospices, helping to secure a reversal of the guidance order earlier this month. In an email to The World last week, the congressman said he “went to bat for organizations such as South Coast Hospice” to prevent federal policy from interrupting or delaying a patient’s access to appropriate medical care. “These nonprofits are doing good work in their communities and the federal government should help them, not hurt them,” he wrote. “There have been rare instances of fraud but in the effort to go after the bad guys we shouldn’t be punishing those organizations providing good services.” That punishment, some hospice officials say, would have likely led to smaller and more rural hospice programs having to close their doors for good. Furman Grile said that she and Karen Schramm, patient care coordinator, were asked to represent South Coast Hospice as part of a five-person Oregon contingent that was going to ask Congress to back them in their efforts to get a reversal of that order. While the decision had created a huge financial burden for the nonprofit programs, she said it also had other repercussions that would affect those going through end-of-life care. One of the unintended consequences of the guidance, which went into affect in May, was that patients were being bounced back and forth between hospice and the pharmacy whenever they tried to fill prescriptions for conditions not related to the admitting illness. Pharmacists also complained because of the chaos it had created. “It was really limiting care to people and misplacing a burden that was not hospice’s burden to have to carry,” she said. “We provide the comfort and quality of care related to the disease of admission, but all of the ancillary care that (patients) needed throughout their life could not be put upon hospices to cover at the end of one’s life when they are in a hospice program. How would hospices ever survive that? And it really, really did not enhance the patients’ end-of-life quality to have to be bounced around like a pingpong ball.” That message was centralized and delivered to Congress by the Oregon delegation, along with delegations from 46 other states, leading to the successful turnaround of that order July 18. The National Hospice and Palliative Care Organization, in a policy alert statement, wrote that they were “very pleased with the changes in the revised guidance.” Adding that they accomplished their “primary goal of removing hospice patients and their families from the confusion surrounding the previous policy.” It was news that was warmly greeted by hospice employees all over the country, but particularly for those in rural programs like the one in Coos Bay. “It was the most exciting news to know that things can change in the federal government when the people speak up,” Grile said. “It was just incredible to get to go back to Washington, D.C., and be part of something (like this).” From Coos Bay
Posted on: Tue, 29 Jul 2014 21:47:00 +0000
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