The Congress should direct the Secretary to:
* Require that a hospice physician or advanced practice nurse visit the patient to determine continued eligibility prior to the 180th-day recertification and each subsequent recertification and attest that such visits took place,
* Require that certifications and recertifications include a brief narrative describing the clinical basis for the patient’s prognosis, and
* Require that all stays in excess of 180 days be medically reviewed for hospices for which stays exceeding 180 days make up 40 percent or more of their total cases.
Reforming Medicare’s hospice benefit (2A)
February 26, 2009