Seniors will not have to stop curative care to receive hospice benefits under a new demonstration program, the Centers for Medicare & Medicaid Services recently announced.
The current rule has created a “false choice” between the two types of care, said Sen. Ron Wyden (D-OR). Wyden was the architect of the program unveiled in late March called the Medicare Care Choices Model.
Through the Choices program, Medicare will reimburse hospices $400 a month for “routine home care and inpatient respite levels of care” that are not eligible to be billed under other parts of the Medicare program, according to a CMS fact sheet. Providers and suppliers offering the hospice patient “reasonable and necessary” curative services also will be eligible for reimbursement. The program initially will be limited to certain conditions, including congestive heart failure and chronic obstructive pulmonary disease.
The hospice benefit is intended for Medicare beneficiaries who have an expected lifespan of six months or less. However, most people don’t enter hospice care until their final days, possibly because they are pursuing curative treatment until that time, according to CMS. The demonstration is meant to test whether beneficiaries will pursue hospice care earlier.
The program should allow Medicare beneficiaries to access “innovations” in care that have “long benefited patients in the private market,” said Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization.
Providers can apply through June 19, according to a notice in the Federal Register.