Medicare now requires physician essays for hospice care, as if pre-authorizations weren’t bad enough

Perhaps this unsuprising growth in bureaucracy is really a new form of cancer, or perhaps something in the water or air or the Potomac Vapors seeping throughout the entire country.
Chuck Brooks
FutureWare SCG

While I can understand the red tape concerns, I wonder how many doctors readily approve hospice on request. Is the 6-month requirement seriously considered by physicians? How often do they say no?

Good grief! Would Medicare rather have patients stay in the hospital for their last days…weeks? Physicians should be doing what they studied to do…practice medicine! Do they now have to hire an essayist to document, in proper English, why a patient needs Hospice? And, I never met anyone that has their expiration date stamped on their behind, so it’s the physician’s best guess as to how long a patient has!

Another unspeakably stupid idea brought to you by the Centers for Medicare Services.

Let’s just quash the Part B program rather than make it so administratively unworkable that no one will want to deal with it anyway, the way we are going.

that explains why I was asked to write “Patient expected to live less than six month” in my last progress note before discharge from the the hospital to hospice.

Apparently, that was my essay.

All the “pity the poor doctor” wailing would be tempered a bit if you had the experience I have had with reviewing cases that are enrolled in hospice when there is no oversight–some of the most ridiculous “terminal” diagnoses listed that you can imagine. Hemorrhoids, psoriasis, you name it. It is a natural result of the government paying that they are going to start doing things to stop themselves from being repeatedly and systematically scammed. To do less is malfeasance. Do more to enforce ethics of honesty and integrity among our colleagues, and encourage the system to be more bold to boot the scammers out of the program, and we will have less red tape burden on the rest of us.

“……If Medicare is paying for hospice care for hemorrhoid patients, that is a failure of Medicare’s internal oversight procedures……”

Exactly.

That’s like the days when you could set up a mail drop, call yourself a DME vendor, get a bunch of Social Security numbers, bill a bunch of quad canes and manual wheelchairs and stuff that doesn’t grab much attention, get paid what you’re paid, and close the mailbox before Medicare got wise.

This stuff reflects failure of Medicare to do the most basic oversight. Don’t blame the doctors “conspiracy of silence”, blame Medicare lack of oversight and the medical board failure to police some of these basics. In the meantime, they spend money going after docs for failure to get the Urdu translator or figuring out if we’re going after the docs for undertreating pain or giving too many controlled drugs. Flip a coin.

And “pity the poor doctor” wailing……..get a clue pal. There’s a billing code for this, and Medicare actually pays for that essay. So there’s that much more money going out of the system.

Oh, and money like that, payments like that to physicians, doesn’t get counted as “administrative”. Makes the funny math easier when the single-payer advocates make their push for “Medicare for all”.