Monday, October 8, 2018

Study uncovers questionable Hospice care and financial fraud in the US.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

From its inception, the Euthanasia Prevention Coalition (EPC) has promoted good hospice and palliative care. One of the founding purposes of EPC is:
To promote improvement in the quality and availability of hospice/palliative care, and effective methods of controlling pain and suffering.
Debate about the Palliative Care and Hospice Education Training Act (PCHETA), S. 693 / H.R. 1676, has grown since the Association of American Physicians and Surgeons opposed the legislation.

The EPC promotes good hospice and palliative care and we urge that physicians and nurses be properly trained in pain and symptom management. It is a tragedy when a person seeks out death by lethal drugs (assisted suicide) because they have not received effective care.

Concerns about the S.693/H.R 1676 stem from two main concerns: the lack of clear definitions in the bill and the abuse of hospice/palliative care.

The lack of clear definitions is important since a goal of the assisted suicide lobby is to normalize assisted suicide by infiltrating palliative care. The abuse of hospice/palliative care creates significant concern since S.693/H.R 1676 provides millions of dollars for hospice/palliative care services.

A few months ago, the US Department of Health & Human Services - Office of Inspector General issued a report titled: Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio. The study found:
Hospice care can provide great comfort to beneficiaries and their families and caregivers at the end of a beneficiary's life. Hospice use has grown steadily over the past decade, with Medicare paying $16.7 billion for this care in 2016. It is an increasingly important benefit for the Medicare population; 1.4 million beneficiaries received hospice care in 2016. 
However, OIG has identified vulnerabilities in the program. OIG found that hospices do not always provide needed services to beneficiaries and sometimes provide poor quality care. In some cases, hospices were not able to effectively manage symptoms or medications, leaving beneficiaries in unnecessary pain for many days. 
OIG also found that beneficiaries and their families and caregivers do not receive crucial information to make informed decisions about their care. Further, hospices' inappropriate billing costs Medicare hundreds of millions of dollars. This includes billing for an expensive level of care when the beneficiary does not need it. Also, a number of fraud schemes in hospice care negatively affect beneficiaries and the program. Some fraud schemes involve enrolling beneficiaries who are not eligible for hospice care, while other schemes involve billing for services never provided. 
Lastly, the current payment system creates incentives for hospices to minimize their services and seek beneficiaries who have uncomplicated needs. A hospice is paid for every day a beneficiary is in its care, regardless of the quantity or quality of services provided on that day. While CMS made some changes to payments, the underlying structure of the payment system remains unchanged.
For the sake of the patients and care-givers and to protect the culture from the promotion of assisted suicide, concerns about the delivery of hospice/palliative care need to be repaired. It is not acceptable that people who are seeking pain and symptom management not receive it and that financial fraud be connected to the care of people while they are at a vulnerable time of their life.

EPC supports excellent pain and symptom management becoming mainstream in providing medical treatment rather it becoming the domain of specialists. People want to die at home and not within institutions who are making huge profits.


unhappygrammy said...

Before Medicare pay's patients Hospital bills, instead of just scanning over documentation, the medical files need to be gone through THOROUGHLY. As in my husband's case the bills were paid for Hospice/Palliative care that we never signed for. In fact we refused. Medicare denied he was on Hospice/Palliative care and that they weren't billed for it. They must have been shocked when I sent them ALL the documents proving he was put on it and that Medicare did in fact pay for it. ILLEGAL, NON-CONSENSUAL Hospice/Palliative Care. Imagine that! Paying the bills when no consent forms exist! Medicare is finally going after the money they paid for the
ILLEGAL, NON-CONSENSUAL Hospice/Palliative Care. Medicare FRAUD?????

Deacon Bill Gallerizzo said...

Montgomery County, Maryland has,an in-home hospice care program that allows patients to die at home, peacefully and naturally. My wife's parents died under those circumstances. As my wife was then functioning as their prime caregiver, her brothers and sister all had opportunities to be part of their care when we had other obligations. There were no regrets for most family members, and the type of grief was on the loss, but not the betrayal and anger that comes when life is prematurely snuffed out. In my experience, the conditions are ideal, and the chance of abuse from the outside is minimal.