Wanting to Learn More about Hospice?
In early 2018, Congress passed the Medicare Patient Access to Hospice Act which allowed the Centers for Medicare & Medicaid Services (CMS) to change the regulations to recognize physician assistants as designated hospice attendings effective January 1, 2019.
What does this mean? Bottomline, starting in 2019, PAs will be able to refer their patient's to hospice and remain the attending hospice provider for their patients--a big win for those of us that have had to traditionally hand-off our long time primary care patients to a supervising physician or hospice medical director to follow on hospice. We will be able to follow care, place orders, and bill for patients for whom we are designated as the patient's elected hospice attending. CMS also made note that PAs are part of the interdisciplinary group (IDG) stating, the attending physician, which could include an NOP or PA, does, in fact, play an essential role int he function of the IGD."
One change that was not made was the wording for who can certify terminal illnesses. This still will fall to our physician colleagues with hospice. The law as written, also did not allow PAs to be included as those that can do face-to-face visits during the recertification periods on hospice as our advance practice nurse colleagues currently can with approval from a physician.
Note, each state has it's own statute and limitations for hospice. Some mirror CMS regulations, others do not. We are working with AAPA to help understand what barriers exist for PAs to practice under the new CMS guidelines in their own states.
See the AAPA page with Hospice FAQs.
Keep an eye out on this space for updates and further guidance!
More work to do!
Needing resources on how to care for patients on Hospice?
Visit some of these resources here. Members, more to come on this website to help you prepare for 2019!
End-of-Life Resources --Collection of content from AFP on End-of-Life Care and Resources