Sunday, November 4, 2018

Margaret Dore and Dawn Eskew Take the Lead Against Flawed Hospice Act

Margaret Dore with
Dawn Eskew
The "Palliative Care and Hospice Education and Training Act," bills H.R. 1676 and S. 693, were proposed in 2017 and viewed as noncontroversial. 

In July 2018, H.R. 1676 passed the House. The bill was then received in the Senate and transferred to the Health, Education, Labor and Pensions Committee, which was also considering S. 693.

A week later, the Office of the Inspector General for the U.S. Department of Health and Human Services (OIG) issued a portfolio highly critical of the Medicare hospice benefit. This alerted Dore to some of the bills' problems.

Dore also learned of a Texas case, in which a hospice owner had allegedly ordered staff to administer Schedule II drugs to patients, regardless of need. His alleged reason was to justify higher patient billings, meaning more money for him. The reported result included serious bodily injury and death to the patients involved

Problems with the bills include:
• They do not require patients to be “terminally ill,” which is an eligibility requirement for hospice under Medicare. If the bills are enacted, this omission will create confusion in the law and/or undermine laws designed to prevent patient harm and fraud in the Medicare program.
• The bills describe hospice and palliative care as a benefit for patients and their families, who can have divergent interests. Patients may want to get well, while their families may want inheritances. This is a fundamental problem with the bills, that as written, they serve two masters. 
In early October 2018, Dore, assisted by Dawn Eskew of New York Against Assisted Suicide, went to the US Capitol with a formal analysis of the bills' problems. The staff person at their first appointment told them that no other visitor had expressed opposition to the bills. 

Dore's analysis can be viewed at the bottom of this press release, titled: "Proposed Federal Hospice Act Must be Defeated to 'Stop the Waste, Bleeding and Heartache."

As of November 4, 2018, both bills are still in the Senate Health, Education, Labor, and Pensions Committee (HELP).