Medicare patients who choose hospice or palliative care are entitled to participate in their treatment plan and have the right to effective pain management, the right to refuse treatment, and the right to choose their physician, according to a soon-to-be-published rule from the CMS. The changes are considered the first overhaul of hospice-related regulations since 1983.
End-of-life care has changed markedly in the past 25 years, and it is time to update our regulations to reflect advances in medicine and hospice industry practices as well as patient rights, said Kerry Weems, acting administrator of the CMS, in a news release about the rule, which is the first to outline a detailed list of patient rights even though many hospice patients already participate in their treatment plans.
The 758-page regulationalso referred to as the hospice conditions of participationreflects comments received since a proposed rule was issued in May 2005, the CMS said. In addition to the section on patients rights, the final rule includes a requirement that patient needs be assessed within 48 hours of electing the hospice benefit, and that a comprehensive assessment occur within five days of choosing hospicewith updated assessment at least every 15 days thereafter. There is a also a provision that allows a hospice to contract with another Medicare-certified hospice for nursing, medical social services and counseling services under extraordinary or other nonroutine circumstances, including a patient traveling outside the hospices service area.
Nearly 1 million Medicare beneficiaries are receiving care from more than 3,000 Medicare-approved hospices, according to the CMS. The agencys regulation will be published in the Federal Register on June 5. -- by Jessica Zigmond
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