NAHC & 3 Other Orgs Talk Hospice Program Integrity with CMS Admin

The National Association for Home Care & Hospice (NAHC) and three other organizations – Leading Age, the National Hospice and Palliative Care Organization (NHPCO), and the National Partnership for Healthcare and Hospice Innovation (NPHI) – met with Centers for Medicare and Medicaid Services’ (CMS) Administrator Chiquita Brooks-LaSure to share concerns and recommendations to address the…

What You Need to Know About the Revised Hospice Survey Process

Tuesday,  February 14, 2023 12:30 – 1:30 PM EDT REGISTER Medicare hospice surveyors are now utilizing a significantly reformed survey process that focuses on the quality of care. Surveyors will target four core conditions of participation and review more records under the new process. There is also an emphasis on patient interviews. Hospices need to…

What You Need to Know About the Revised Hospice Survey Process

Tuesday,  February 14, 2023 12:30 – 1:30 PM EDT REGISTER Medicare hospice surveyors are now utilizing a significantly reformed survey process that focuses on the quality of care. Surveyors will target four core conditions of participation and review more records under the new process. There is also an emphasis on patient interviews. Hospices need to…

Physicians Practicing with an MBBS Degree

The National Association for Home Care & Hospice (NAHC) has increasingly been receiving questions regarding whether a practitioner with an MBBS credential is permitted to certify and order services for home health patients. It was noted that many of these practitioners have an enrollment record in the Provider Enrollment, Chain, and Ownership System (PECOS). NAHC…

NAHC and CMA Announce New Hospice Resource for Consumers

Over 1.7 million Medicare beneficiaries receive hospice care1. It is one of many benefits available under Medicare and provided by approximately 5,000 Medicare-certified hospices. Each of these hospices must provide certain services and meet specific requirements. However, each can provide these services in different ways. Navigating the details can be confusing, leading to many questions and misunderstandings. Making the decision to choose hospice care and choosing a hospice provider are two of the most important decisions anyone will make for themselves or a loved one. Finding a hospice that meets the needs of each patient may take some time.

To help beneficiaries sort through the details and learn about the hospice options available under the Medicare Hospice Benefit, the Center for Medicare Advocacy (CMA) and the National Association for Home & Hospice Care (NAHC) jointly developed “Questions to Ask When Choosing a Hospice.” These questions are intended to prompt discussion between beneficiaries and hospices so that patients fully understand coverage under the Medicare Hospice Benefit and how these services are provided by the hospice they are considering.

“With a growing use of hospice care, it is essential that Medicare beneficiaries and their families are well-equipped to understand what it takes to choose the right hospice,” said NAHC President William A. Dombi. “We are proud to have the opportunity to team-up with the Center for Medicare Advocacy to contribute well-focused guidance on hospice care and provider options. There are few health care decisions that one may make that are more important than selecting a qualified hospice provider.”

“As patients face terminal illness, the decision to choose hospice care is complex, and often difficult. We hope this document will help patients and families understand Medicare hospice coverage, the benefit from receiving hospice care, and available provider options. The booklet includes questions and guidance we hope will be valuable in finding care people can rely on as they live with serious illness,” said Judith Stein, Executive Director, Center for Medicare Advocacy. The “Questions to Ask When Choosing a Hospice” document is available on the CMA website and the NAHC website.

1MedPAC Report to the Congress (March 2022):

CMS Proposes Modifications to Requirements for Electronic Prescribing of Controlled Substances

We want to know what you think! Please submit any comments on this to Theresa Forster of the NAHC staff at As part of the calendar year (CY) 2022 physician payment rule, the Centers for Medicare & Medicaid Services (CMS) promulgated significant regulations implementing Section 2003 of the Substance Use-Disorder Prevention That Promotes Opioid Recovery…

FY2023 Hospice Medicare and Medicaid Base Rates at a Glance

–Hospice Medicare FY2023 Pricer Now Available Beginning October 1, 2022, hospice base payment rates will increase by 3.8 percent, as published in the final FY2023 Hospice Payment Rule. As is customary, the Medicaid program waits until Medicare rates are finalized to issue guidance on the applicable corresponding hospice payment rates. The Centers for Medicare &…

CMS Project Targets Providers for Deactivation

NAHC has recently become aware of a project the Centers for Medicare & Medicaid Services (CMS) has initiated that could have an especially negative impact on home health agencies that are not serving Medicare beneficiaries but are required to be Medicare-certified to meet state or non-Medicare payer requirements.  The project is titled “Organization Deactivation Project…

Choose Home Care Act Picks Up Support in Congress

  • Click Here to Urge Congress to support the Choose Home Care Act!

The Choose Home Care Act continues to build support in Congress with the recent addition of new cosponsors in the House of Representatives, including Reps. Sheila Cherfilus-McCormick (D-FL-20), Brian Fitzpatrick (R-PA-1), Al Lawson, Jr. (D-FL-5), and Angie Craig (D-MN-2).

We thank the new sponsors of this legislation for their leadership on this issue.

The Choose Home Care Act seeks to provide an option to patients in where they receive their post-acute care upon discharge from a hospital within the Medicare program. If deemed a good fit by the hospital and home health agency for the Choose Home model, a patient could elect to continue their recovery at home with enhanced services and supports added onto the traditional home health benefit. The added services could include personal care services, meal delivery, and respite care, among several others.

The Choose Home Act is a top legislative priority for NAHC. In addition, other supporting organizations include AARP, the Partnership for Quality Home Health Healthcare (PQHH), LeadingAge, the National Council on Aging (NCOA), the Moving Health Home Coalition and others.

Imminent legislative activity is not expected as attention will shift towards reelection campaigns during the summer and early fall. In the meantime, NAHC will continue to build knowledge of the legislation on Capitol Hill, as well as add new supporters to optimize the Choose Home Care Act‘s chances of coming up for a vote.

NAHC encourages all members and home care professionals to urge their Senators and Representatives to support the bill. This can easily be done through the NAHC Legislative Action Center here.

Hospice Notes for July 13, 2022

Congress is facing a packed few weeks in the lead-up to the monthslong August recess. The potential revival of a slimmed-down reconciliation package sought by Senate Democrats remains top-of-mind for many DC watchers. While nothing is concrete at this point, it unfortunately appears likely that any smaller party-line reconciliation bill will omit major funding investments in Medicaid home-and-community-based services (HCBS). Last year’s House-passed Build Back Better Act included $150 billion for HCBS, seen as a transformative injection of resources that would increase access and better support the frontline home care workforce.

NAHC continues to work with other diverse coalitions to push for the inclusion of HCBS funding in any emerging deal.

Elsewhere on Capitol Hill, the House Appropriations committee recently approved a number of FY2023 government funding bills, including the Labor, Health and Human Services, Education, and Related Agencies (LHHS) package that contains discretionary spending for federal health programs. While it is certain that future Senate-side bipartisan negotiations will ensure any final government funding package that will ultimately become law will differ from what the House Appropriations committee has cleared, it is still instructive to keep track of the Democrat-led House deal, as it provides insight into that group’s policy priorities. A few provisions relevant to home-based care providers, detailed in the bill’s accompany report, include the following (note -many of these are merely signaling in nature, as opposed to explicitly directive):

  • Medicare Coverage of Home-based Extended Care Services.—The Committee encourages CMS to consider options to improve extended care services for Medicare beneficiaries, such as through home-based extended care by home health agencies (bottom of pg 184)
  • Patient Access to Home Health Care.—The Committee supports the intent of the network adequacy rules of CMS for Medicare Advantage organizations and for Medicaid managed care organizations under 42 C.F.R. 438 and 457 to maintain a network of qualified providers sufficient to provide adequate access for covered services to meet the health care needs of the patient population served. The Committee requests a report within 180 days of the date of enactment of this Act on regulatory actions related to network adequacy (bottom of pg. 186)
  • Home Health Aides.—The Committee recognizes that home health aides (HHAs) are the foundation of professional home-based caregiving, and that the growing population of disabled, chronically ill, and elderly Americans receiving home-based care requires a skilled and highly trained HHA workforce prepared to manage complex care needs. The Committee encourages HHS to explore how HHAs are meeting clinical competencies necessary to provide high-quality home-based care (pg. 221)
  • Direct Care Workforce Demonstration.—The Committee provides $3,000,000 for a Direct Care Workforce Demonstration project, to reduce barriers to entry for a diverse and high-quality direct care workforce, including providing wages, benefits, and advancement opportunities needed to attract or retain direct care workers. (pg. 211)
  • Dementia Care Management Model.—The Committee urges the Center for Medicare & Medicaid Innovation (CMMI) consider how best to test a Medicare dementia care management model. The Committee encourages CMMI to continue working with stakeholders to find a way to test a value-based dementia care management model that could reach dementia patients across the stages and include coordinated care management and caregivers. The Committee requests an update not later than one year after the date of enactment of this Act on the progress for this model. (pg. 180)

The bill also includes several provisions that would help to increase the health care workforce. Among other things, the bill includes: nearly $2 billion in new money for the Department of Labor, including for apprenticeship programs, Workforce Innovation and Opportunity state grants, and Senior Community Service Employment; $15,6 billion in new money for HHS to enhance nursing workforce development and other health care programs; and enhanced funding for targeted programs of the Administration on Community Living.

The Committee also adopted a manager’s amendment from House Appropriations Committee Chairwoman Rosa DeLauro (D-CT), that added language to the committee report that urges the Health Resources and Services Administration  (HRSA) to “address the skilled care workforce needs of seniors through existing workforce education and training programs.”

The most hospice and palliative care-specific bills in Congress right now include the Palliative Care and Hospice Education and Training Act (PCHETA) (S.4260) and the Expanding Access to Palliative Care Act (S. 2565). PCHETA would bolster the serious illness professional workforce and boost palliative and hospice research funding, while S.2565 would require CMMI to test a dedicated community-based palliative care demonstration informed by the recently-ended, hospice-only Medicare Care Choices Model (MCCM). Both bills are currently Senate-only at this point, and we need your continued advocacy and outreach to continue to garner co-sponsors for these important policies. Use NAHC’s grassroots outreach campaigns to ask your Senators to support these bills.

Elsewhere in DC, much of the policy conversation on palliative care in particular is occurring within CMMI. In light of the Innovation Center’s strategic refresh late last year, it has become apparent that leadership there is focused on streamlining their demonstration portfolio and developing ways to better integrate specialty care (which is how they conceptualize palliative care) into broader, population health-style models, primarily the ACO programs.

Recently, CMMI posted a blog that broadly spells out their early vision for this kind of integration. In the piece, they specifically write: “Until more ACOs can assume full risk, collaborative care codes, as currently used in behavioral health, could support integration and co-location of some specialty care, such as palliative care.”

NAHC, in tandem with other members of the National Association of Hospice & Palliative Care, continues to work with CMMI to explore how best to support and scale home and community-based palliative care.