More than 240 hospice advocates have converged on Capitol Hill Tuesday, in efforts to call on Congress to temporarily halt implementation of CMS actions they say are leaving hospice patients without medications they need at the end of life.
The campaign is spearheaded by the Hospice Action Network (HAN) and the National Hospice and Palliative Care Organization (NHPCO), which will hold Congressional meetings with 330 offices as part of their annual Advocacy Intensive.
The event will zero-in on two key issues concerning the nation’s hospice community, including the Centers for Medicare & Medicaid Services’ (CMS) guidance regarding Medicare Part-D and prescription drug payments for hospice patients.
The guidance, issued in March 2014, introduces a “prior authorization” process for how Part D providers and hospice communities should determine who pays for which drugs once an individual enters hospice.
“Congress have called for CMS to slow the process and convene the stakeholders to create the appropriate communication channels and processes for prior authorizations,” HAN and NHPCO write. “However, CMS has provided little instruction and absolutely no infrastructure to ensure that hospices and Part D plans can successfully implement this process without impacting patient access to medications.”
Another focus for advocates will be the presence of reimbursement cuts amid increasing regulatory and administrative burdens, along with the prospect of additional changes to the Medicare Hospice Benefit that may happen in the near-future.
Because hospice serves a clientele that is facing their final days, weeks or months of their lives, advocates are urging for an imminent halt to the CMS requirements.
“The policy itself is not the issue, the problem is that there is no existing infrastructure in place to support the Guidance by CMS and protect the patient,” stated J. Donald Schumacher, NHPCO president and CEO. “One of the primary purposes of this event is to convene a robust a diverse group that could share the stories of hospice with members of Congress.”
More than 1.5 million patients, along with their family caregivers, receive hospice care in the U.S. each year, according to NHPCO data.
Written by Jason Oliva