FY2022 Hospice Proposed Rule -- Survey of Election Statement Addendum and Proposed CoP Changes

Issues Related to the Election Statement Addendum and CoP Waivers

Issues Related to the Election Statement Addendum

As part of the FY2022 proposed hospice payment rule, CMS provided clarification to issues and questions about the election statement addendum. Key provisions are listed below with an opportunity to comment on each.

Issues with "Relatedness" and Impact of Using the Election Statement Addendum

As part of the rule's discussion on hospice utilization and spending trends, CMS is seeking input on hospices' determinations as to what items, services and drugs are related versus unrelated to the terminal illness and related conditions. CMS is also seeking input on the impact of use of the Election Statement Addendum on care decisions.

Hospice CoP Waivers

As part of the rule, CMS is proposing to make permanent two CoP waivers that have been effective during the COVID-19 Public Health Emergency. CMS is proposing, on a permanent basis, to:

Permit the use of pseudo-patients as part of a simulation for hospice aide training and evaluation, and
Permit hospices to conduct a targeted competency evaluation focused on specific hospice aide deficiencies identified during the on-site RN supervisory visit (in lieu of a full competency evaluation).

Please provide answers to any of the following questions addressing these subject areas. For additional details, please consult NAHC's summary of the proposed rule.

Question Title

* 1. Do you agree with the clarifications and regulatory changes CMS has proposed for the election statement addendum? Please provide any additional recommendations you may have for modifications to the election statement addendum requirements.

Question Title

* 2. How does your hospice make determinations as to what items, services and drugs are related versus unrelated to the terminal illness and related conditions? That is, how do you define what is unrelated to the terminal illness and related conditions when establishing a hospice plan of care? Likewise, what other factors may influence whether or how certain services are furnished to hospice beneficiaries?

Question Title

* 3. Has the hospice election statement addendum changed the way your hospice makes care decisions? If so, how?

Question Title

* 4. Does your hospice use the Election Statement Addendum to prompt discussions with beneficiaries and non-hospice providers to ensure that the care needs of beneficiaries who have elected the hospice benefit are met?

Question Title

* 5. Do you support CMS' proposed CoP changes that would allow use of pseudo patients as part of a simulation for hospice aide training and evaluation and use of targeted competency evaluations for aides? Are there other CoP PHE waivers that you would recommend CMS make permanent?