CMS Part D policy hurting hospice patients and families

A hospice patient in Oklahoma City is being denied his medications to treat his COPD, while coping with a diagnosis and treatment for tongue cancer.  In Cadillac, Michigan a patient struggling with colon cancer is being denied insulin to treat his diabetes and is in danger of diabetic shock.

Due to a recent and poorly thought out Medicare Part D Prescription Drug policy, dying patients are revoking hospice services to maintain access to other necessary prescriptions for diseases unrelated to their terminal illness that Part D have paid for until recently. 

Patients’ families are left at the pharmacy counter with no refill of medications, after the pharmacist announces that because the patient is on hospice, the pharmacy is no longer allowed to fill their prescriptions – which in not accurate.  Or they are going days, sometimes weeks, without the necessary medication to manage symptoms that were present before they elected the hospice benefit due to unnecessary complications in approving prescriptions under Part D.

The intention of the new Medicare Part D policy implemented by the Centers for Medicare and Medicaid Services is to prevent the federal government from incurring duplicate costs for medications of hospice patients. 

The National Hospice and Palliative Care Organization has strongly opposed the inadequate and haphazard implementation of this guidance. 

NHPCO agrees that hospice providers should be held responsible for all drugs that are related to the terminal diagnoses and those drugs that are unrelated should be billed to Medicare Part D.  

NHPCO acknowledges that there have been instances of Part D payment for drugs that should have been covered by the hospice provider under the Medicare hospice benefit. 

NHPCO continues to encourage CMS to halt the implementation of the Part D guidance and convene key stakeholder groups to collaborate and create a strategic and uniform process.  An effective solution can be reached so that Part D providers, pharmacists, hospice providers and beneficiaries have developed a coherent process together and hospice patients are not denied the medications they need at the end of life.