Medicare program; hospice care amendments: Medicare--HCFA. Final rule with comment period

Area of Science:

• Healthcare Policy
• Medical Regulations
• Geriatric Care

Background:

• Physician certification of terminal illness is crucial for hospice care eligibility under Medicare.
• Previous certification rules were complex and discouraged physician participation.
• Amendments by the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) necessitated rule revisions.

Purpose of the Study:

• To amend hospice care provisions regarding physician certification of terminal illness.
• To encourage greater hospice participation in the Medicare program.
• To simplify and clarify existing hospice policies.

Main Methods:

• Amending rules to allow 8 days for written certification post-oral certification (within 2 days).
• Modifying the physician certification statement to reduce physician reluctance.
• Aligning Health Care Financing Administration (HCFA) rules with OBRA '89 amendments.
• Incorporating recommendations from the General Accounting Office (GAO).

Main Results:

• Extended timeframe for written physician certification (8 days) with expedited oral certification (2 days).
• Revised certification statement to encourage physician buy-in.
• Simplified and clarified other hospice policies.
• Removed outdated content and corrected cross-references.

Conclusions:

• The rule amendments facilitate hospice care by easing physician certification requirements.
• These changes are expected to increase hospice provider participation in Medicare.
• Policy adjustments support compliance with federal legislation and GAO recommendations.