Lowdown on Medicare Hospice Benefit

The goals of hospice care are to aid terminally-ill beneficiaries carry on living with minimum disruption and to help the near and dear ones of beneficiaries throughout the entire process. This care may be given to individuals and their families either at home or at a skilled or other nursing facility. Counseling, training to provide care for the individual, bereavement counseling, etc. are offered to families and other caregivers.

A 2009 OIG report found out the extent to which hospice claims for beneficiaries in nursing facilities met Medicare coverage requirements. As per the report, 82 per cent of hospice claims for beneficiaries in nursing facilities did not meet one Medicare coverage requirement. Medicare shelled out around $1.8 billion for these claims. Also, the report read that for 31 per cent of claims, hospice provided lesser services than laid down in beneficiaries' plans of care.

To be eligible for Medicare hospice care, a beneficiary must be entitled to Part A of Medicare and must be certified as having a life expectancy of 6 months or less. When a beneficiary is elected for hospice care, the hospice agency takes on all the responsibility for medical care, which is more palliative rather than curative. Beneficiaries stand to receive hospice care for two 90-day periods and unlimited 60-day election periods.

The Medicare hospice benefit has four levels of care which are routine home care, continuous home care, respite care and general inpatient care. Routine home care is the most common level of the lot. Each level has an all-encompassing, prospectively determined daily rate.

For more on Medicare hospice benefit and other hospice news, you can subscribe to various magazines and newsletters.

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