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U.S. Medicare program scales back hospice drugs restrictions
Reuters ^ | July 18, 2014 | David Morgan

Posted on 07/19/2014 5:33:03 AM PDT by Innovative

The Obama administration on Friday backed down on restrictions of private insurance coverage for hospice drugs under Medicare, saying the regulations were preventing some terminally ill patients from having access to medicine.

Under Medicare's Part A hospital program, hospices receive daily payments for each patient but are responsible for all drugs related to a patient's terminal illness. Medicare Part D covers only prescriptions and medications for curative conditions that are unrelated to a terminal illness.

(Excerpt) Read more at reuters.com ...


TOPICS: Extended News; Government; News/Current Events; Politics/Elections
KEYWORDS: deathpanels; drugs; hospice; medicare; medicaredrugs; medications; obamacare; obamacaredrugs
I'll give more links in my next post -- the bottom line is that Obamacare rules implemented recently decreed that Medicare won't pay for ANY medications for people in hospice care and the hospice needs to pay for any and all meds of people in their care -- which of course will mean that either hospices will go out of business, because their reimbursements from Medicare are limited and aren't sufficient to provide meds -- or people won't get their meds. Sarah Palin was right -- this is along the lines of deathpanels, except it became law, once you get into hospice care, no more meds for you, just go scream in pain and die!
1 posted on 07/19/2014 5:33:04 AM PDT by Innovative
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To: All

Initially obamacare rules denied ALL meds to those in hospices, now they revised their guidelines and are “only” denying pain medications

Related article on FR:

Medicare Modifies Controversial Hospice Drug Rule (won’t pay for pain relief pills)

http://www.freerepublic.com/focus/f-news/3182318/posts

See also:

Medicare Seeks To Stop Overpayments For Hospice Patients’ Drugs

May 1, 2014

http://www.kaiserhealthnews.org/stories/2014/may/01/new-medicare-procedures-seek-to-stop-overpayment-of-drugs-for-hospice-patients.aspx

“”Instead of leaving it to insurers and hospice providers to identify the drugs they are responsible for, the new rule sets up a process that requires Part D plans to reject initially any prescription from a hospice patient. The patient or doctor, with the hospice provider’s agreement, must explain to the insurer why the drug is not related to end-of-life care. The insurer may deny coverage for a number of reasons, including if the doctor or hospice did not explain sufficiently why the drug was unrelated to the terminal illness, Medicare officials told hospice organizations and insurers” “


2 posted on 07/19/2014 5:36:26 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Innovative

I am a hospice nurse, and this Obamacare-inspired bullsqueeze has been a NIGHTMARE for everyone involved!

What a clumsy oaf is our current pResident Zero.


3 posted on 07/19/2014 5:37:54 AM PDT by clee1 (We use 43 muscles to frown, 17 to smile, and 2 to pull a trigger. I'm lazy and I'm tired of smiling.)
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To: Innovative

The evil man wants as much pain as possible when someone dies..I really hope OBAMA and his family and rest of the commies have a miserable time when it is over for them..


4 posted on 07/19/2014 5:38:45 AM PDT by PLD
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To: clee1

“What a clumsy oaf is our current pResident Zero.’

He may be, but those who pull his strings are evil and devious.


5 posted on 07/19/2014 5:41:03 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: clee1

Well, well...... someone that knows through experience.

could you advise us about what in your opinion is really happening? Does it effect patients adversely


6 posted on 07/19/2014 5:41:04 AM PDT by bert ((K.E.; N.P.; GOPc.;+12 ..... Obama is public enemy #1)
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To: Innovative

So first Øbama suggests one take the red pill instead of having the operation and then he turns around and denies coverage for the red pill. Those sons of, uh, sea cooks. Hey, maybe if they called it “birth control” he’d be handing them out in person.


7 posted on 07/19/2014 5:44:22 AM PDT by NonValueAdded ("The Arab Spring is over. Welcome to the Jihadi Spring." Jonah Goldberg)
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To: bert

“Does it effect patients adversely”

Are you for real?!!

What do you think denying patients their meds does?!


8 posted on 07/19/2014 5:44:47 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Innovative

Perhaps nothing given the circumstances that meds are no longer effective


9 posted on 07/19/2014 5:47:42 AM PDT by bert ((K.E.; N.P.; GOPc.;+12 ..... Obama is public enemy #1)
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To: Innovative
In Great Britain, people who have no family members to speak up for them are shuttered in the far reaches of a hospice or hospital and not fed or given pain relief. They are expected to die on their own and out of sight and usually do die excruciating deaths alone just because it costs too much to take care of them. Everyone in Great Britain knows this as a reality of their National Health Service. People work to opt for private care if they can afford it. But, those without vocal family members or money are up $#!+ Creek.

This is the slippery slope Sarah Palin warned us about and is already in operation in a country used as an example of what the libs want for us.

10 posted on 07/19/2014 5:47:43 AM PDT by Slyfox (When progressives ignore moral parameters, they also lose the natural gift of common sense.)
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To: Innovative

First it was kill the babies.

Now is it kill the old people too?


11 posted on 07/19/2014 5:51:11 AM PDT by Salvation ("With God all things are possible." Matthew 19:26)
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To: Innovative

FOR THE ELDERLY

Dear Lord,
as my life declines 
and my energies decrease,
more than ever hold me by Your Power,
that I may not offend You,
but daily increase in Your Love.
Give me strength to work in Your Service 
till the last day of my life.
Help me to ever have 
an increasing dread of venial sin,
or whatever would cause 
the slightest withdrawal of Your love,
all day long,
and at night keep me close to Your Heart;
and should I die, ere the morning breaks,
may I go rejoicing in that vision 
of Your entrancing beauty,
never to be separated from You.
 
Amen.

12 posted on 07/19/2014 5:52:02 AM PDT by Salvation ("With God all things are possible." Matthew 19:26)
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To: Innovative

A few more to add to your collection.

DOD MANDATE is forcing us to use either Base whose drugs are limited by size of base and is not wheel chair or handicap friendly or Express Scripts MANDATED Tricare Life. 4/14/14. Express Scripts is a sorry excuse of a provider. You never know if your order is right, what generic, what manufacture, they will over ride a DAW script at their whim or what country. All stuffed into your mail box UN PHOTO ID SIGNED FOR making them available to thieves and meth makers to steal. Or Neighborhood kids to access.
READ THE COMMENTS BEFORE YOU DECIDE TO ALLOW THEM ACCESS TO YOUR BANK OR CREDIT CARD INFO.

BECAUSE OF FED MAIL LAWS NARCOTICS CAN’T BE MAILED. I’d suggest Base use if at all possible. COUNT your pills too. Make SURE YOUR DAW is DAW, ES over rides doctor’s orders. Even if you use base dispensary CHECK before accepting, IF you must have a DAW drug.

Pentagon Outlines Increased Tricare Fee Proposal
http://www.military.com/daily-news/2014/03/05/pentagon-outlines-increased-tricare-fee-proposal.html?comp=7000023317828&rank=1

0bama to Force Military Families Away From Tricare ...By Tripling Their Fees. Patient Protection and Affordable Care Act, aka Obamacare.”

State Side Tricare Service Centers Closing April 1
http://m.military.com/daily-news/2014/01/14/stateside-tricare-service-centers-closing-april-1.html

Tricare PRIME
http://www.armytimes.com/article/20130802/BENEFITS06/308020011/DoD-silent-major-changes-Tricare-Prime
2 links
Starting Oct. 1, the Pentagon plans to reduce Tricare Prime service areas to within a 40-mile radius of active or former military installations, forcing 173,000 retirees and their family members to switch to Tricare Standard or seek a waiver if they live within 100 miles of an existing network.

The decision will affect retirees and their dependents in Prime, and those on Tricare Young Adult Prime. That totals 98,771 people in the Tricare South

Air Force MiCare
http://www.military.com/military-report/air-force-micare?ESRC=miltrep.nl

DoD silent on major changes to Tricare Prime
http://www.armytimes.com/article/20130802/BENEFITS06/308020011/DoD-silent-major-changes-Tricare-Prime

Proposed TRICARE FEE CHANGES
http://www.military.com/benefits/tricare/retiree/proposed-tricare-fee-changes.html

CBO: The military is getting squeezed for domestic spending cash
http://www.humanevents.com/2014/02/26/cbo-the-military-is-getting-squeezed-for-domestic-spending-cash/

Express Scripts Accused Of Defrauding State And Consumers Out Of Millions Of Dollars
http://www.ag.ny.gov/press-release/express-scripts-accused-defrauding-state-and-consumers-out-millions-dollars

NY attorney general sues Express Scripts, Benefits firm accused of inflating prices, keeping up to $100 Million
http://www.nbcnews.com/id/5601076/ns/business-corporate_scandals/t/ny-attorney-general-sues-express-scripts/#.U381ECh7SMQ

Express Scripts Extortion Scheme Widens
http://www.consumeraffairs.com/news04/2009/09/express_scripts_breach.html

Express Scripts complaints
http://www.consumeraffairs.com/rx/express_scripts.html

ES Customer Service ranking
http://www.customerservicescoreboard.com/Express+Scripts

Express Scripts RIP OFF
https://www.ripoffreport.com/reports/directory/express-scripts

ES buys out Medco
29 Billion
http://www.modernhealthcare.com/article/20120402/NEWS/304029961

Senior Vets should be shot
http://www.redflagnews.com/headlines/va-supervisor-older-veterans-should-be-shot-in-the-head-to-save-money


13 posted on 07/19/2014 5:53:51 AM PDT by GailA (IF you fail to keep your promises to the Military, you won't keep them to Citizens!)
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To: Innovative

Same as giving them the WRONG one. We have seen this with Justina P, case, but there are OLDER ones than that. We had a kid at St Judes, that needed an experimental drug, the company denied it, it took a huge public out cry for them to reverse the decision. News report says He is doing very well and is ready to go home. He does have to have monthly check ups at St Judes for about a year. But the result was a success, and the little boy was not a death stat.

Damaged Care
http://www.washingtonpost.com/wp-srv/liveonline/02/health/health052102.htm

First do No HARM
http://www.psychologytoday.com/blog/the-superhuman-mind/201212/first-do-no-harm

Lorenzo’s oil
http://www.sciencebasedmedicine.org/lorenzos-oil/

The Ketogenic Diet Works; A Mom Reflects on the Success
http://epilepsymoms.com/blog/complimentary-alternative-therapies/ketogenic-diet-works-mom-reflects.html

http://www.myelin.org/lorenzosoil/lorenzosoiltheoil.html


14 posted on 07/19/2014 5:59:36 AM PDT by GailA (IF you fail to keep your promises to the Military, you won't keep them to Citizens!)
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To: bert

OH YEAH!

OK, say I have a cancer patient: My company pays for pain meds, anxiety meds, constipation, fever..... you know - symptoms related to their terminal disease.

Soooo.... Most of my patients have issues OTHER than their terminal disease; say high blood pressure, heart problems, or diabetes. In many cases, folks have been on the correct medications for these conditions for decades!

All of a sudden, just because they were on Hospice, Medicare just decided they weren’t paying for these “other condition maintenance meds” any more. They did this overnight one night with NO prior warning to anybody.

What a mess. We were all jumping through hoops and layers of bureaucrats just to get meds for our patients!

Say you’re dying of cancer but have a few months left. You are trying to enjoy what time you have left with your family. All of a sudden, you can’t get your diabetes medication. Your blood sugar shoots up. When your sugar is up your immune system is compromised. You get pneumonia and die. The cause of death was pneumonia secondary to hyperglycemia; not cancer.

The bureaucrats killed one of my patients MONTHS before his time in just that fashion.


15 posted on 07/19/2014 6:04:13 AM PDT by clee1 (We use 43 muscles to frown, 17 to smile, and 2 to pull a trigger. I'm lazy and I'm tired of smiling.)
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To: clee1

Thanks for sharing your experiences.

” You get pneumonia and die.” — this IS the objective. The sooner the patients die, the more money is saved, this is the objective of Obamacare. To think that many older people voted for him because they believed the lies Obama told them that Republicans are trying to take away their Medicare.

This needs to be publicized, people need to wise up, preferably before the next elections.


16 posted on 07/19/2014 6:09:32 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: bert

You mean like feeding a dead horse?

When your time comes, I think you’ll want the medications, and won’t consider them a waste.


17 posted on 07/19/2014 6:16:05 AM PDT by BykrBayb (World Lung Cancer Day {WLCD} Aug 1 https://facebook.com/events/309580722464921 ~ Þ)
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To: clee1
Say you’re dying of cancer but have a few months left. You are trying to enjoy what time you have left with your family. All of a sudden, you can’t get your diabetes medication. Your blood sugar shoots up. When your sugar is up your immune system is compromised. You get pneumonia and die. The cause of death was pneumonia secondary to hyperglycemia; not cancer.

Thanks, this explains an important point.

Sometimes, especially with out-patient hospice, it takes time for the terminal disease to run its course.

18 posted on 07/19/2014 6:18:11 AM PDT by magellan
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To: Salvation

Thank you for that beautiful prayer.


19 posted on 07/19/2014 6:19:01 AM PDT by BykrBayb (World Lung Cancer Day {WLCD} Aug 1 https://facebook.com/events/309580722464921 ~ Þ)
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To: Innovative

There are only two ways you aren’t going to be adversely effected by the Demonic Party’s MarxistPOSCare - 1) By not getting sick or injured, and 2) by not getting old. Anybody that votes for a Demonic Party representative is either evil, ignorant beyond measure, or mentally ill...


20 posted on 07/19/2014 6:19:57 AM PDT by Common Sense 101 (Hey libs... If your theories fly in the face of reality, it's not reality that's wrong.)
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To: Innovative

There are only two ways you aren’t going to be adversely effected by the Demonic Party’s MarxistPOSCare - 1) By not getting sick or injured, and 2) by not getting old. Anybody that votes for a Demonic Party representative is either evil, ignorant beyond measure, or mentally ill...


21 posted on 07/19/2014 6:19:57 AM PDT by Common Sense 101 (Hey libs... If your theories fly in the face of reality, it's not reality that's wrong.)
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To: Innovative
The sooner the patients die, the more money is saved, this is the objective of Obamacare.

Correct. It is in direct conflict with the individual patient's objective, which is to extend their life. It is truly astounding that so many brain-dead libtards and the other apathetic masses fail to grasp this reality... they will eventually, but by then it will be too late.

22 posted on 07/19/2014 6:23:58 AM PDT by Common Sense 101 (Hey libs... If your theories fly in the face of reality, it's not reality that's wrong.)
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To: clee1

{ am a hospice patient. I only have Medicare A and B. I have no other illness than Idiopathic Pulmonary Fibrosis for which I get 02, morphine, a muscle relaxer due to the IPF cough and a sleeping pill. I have had no trouble getting my meds at all. If I don’t get the 02 and morphine, I will be dead within the hour.


23 posted on 07/19/2014 6:26:39 AM PDT by Coldwater Creek
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To: Innovative

Very true. Valerie Jarrett will have blood on her hands, which in any case she will any way.


24 posted on 07/19/2014 6:29:05 AM PDT by Coldwater Creek
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To: PLD

I pray for the traitor’s death every day..a painful death.


25 posted on 07/19/2014 6:35:52 AM PDT by itssme
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To: Coldwater Creek
Bless you, Coldwater Creek. You will be in my prayers daily.
26 posted on 07/19/2014 6:38:22 AM PDT by itssme
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To: clee1

Between the drug regulation nightmare and the required pigeonhole diagnosis and duplicate charting requirements, it is a nightmare. another hospice nurse


27 posted on 07/19/2014 6:40:27 AM PDT by az wildkitten (8 years 'til I retire)
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To: Innovative

more evil this morning.


28 posted on 07/19/2014 6:41:38 AM PDT by MarMema (Run Ted Run)
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To: Common Sense 101
The object of hospice is not to extend your life, but to make one as comfortable as possible while letting the disease run its course. My death certificate will say pneumonia/heart attack or what ever due to compliatons of Pulmonary Fibrosis. or vice versa.
29 posted on 07/19/2014 6:46:09 AM PDT by Coldwater Creek
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To: magellan

Ideally, patients get into hospice a few months before they die to actually benefit from the service. The Nazis(CMS) have our administrators and physicians so cowered, they are reluctant to admit anyone who isn’t almost actively dying. This makes it difficult to manage efficiently making hospices go broke (and we are non-profit but if you can’t pay the bills you can’t survive)

Really frustrating professionally, I don’t think there is anything wrong with admitting someone, adjusting their medications, improving their state of health and discharging them which can and does happen with end stage cardiac, pulmonary and kidney conditions. A little morphine which was the drug of choice for these conditions for centuries can make a big difference at the end of the road. Sometimes more than a year of good quality time.


30 posted on 07/19/2014 6:49:18 AM PDT by az wildkitten (8 years 'til I retire)
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To: Coldwater Creek

Prayers for you.


31 posted on 07/19/2014 6:53:12 AM PDT by Salvation ("With God all things are possible." Matthew 19:26)
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To: az wildkitten

I was terminal from point of DX. I will choke or smother to death without the morphine. I cannot imagine my Christin based hospice allowing this to happen.


32 posted on 07/19/2014 6:53:41 AM PDT by Coldwater Creek
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To: az wildkitten

I have been on home hospice for 9 months. My DX is Idiopathic Pulmonary Fibrosis.


33 posted on 07/19/2014 7:01:28 AM PDT by Coldwater Creek
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To: itssme

AMEN!!!

I PRAY THE SAME PRAYER!!!


34 posted on 07/19/2014 7:10:22 AM PDT by PLD
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To: az wildkitten

Our intermediary doesn’t require pigeonhole dx anymore.... we use the REAL ICD-9 for the 6 moth prognosis.

Hell of alot less ADRs too.


35 posted on 07/19/2014 11:57:23 AM PDT by clee1 (We use 43 muscles to frown, 17 to smile, and 2 to pull a trigger. I'm lazy and I'm tired of smiling.)
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To: az wildkitten

I have 2 patients that are on with us going on 3 YEARS! We got them stabilized and they continue to decline, continue to have < 6 moth prognosis.... but because they are cared for so well, they get some longevity as well as quality of life.


36 posted on 07/19/2014 12:00:42 PM PDT by clee1 (We use 43 muscles to frown, 17 to smile, and 2 to pull a trigger. I'm lazy and I'm tired of smiling.)
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To: clee1

We had someone who lived for 6 years! She was the rarest of exceptions, of course. Then there are always those who die only hours after going on service. There are far too many of them. I think of all the palliative care they missed out on by the delay of decision either by their doctors, their families or the patients themselves.


37 posted on 07/22/2014 9:17:40 AM PDT by ru4liberty
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To: ru4liberty

100% agreed.

I have, literally, gotten in Doctor’s faces and DEMANDED an order to eval.

If the Pt./family want it and they are appropriate, I refuse to let some puffed up toad with an overinflated ego keep someone form appropriate palliation because the MD refuses to accept futility.

Nurses, beyond any other duty, are supposed to ADVOCATE for their patients. I’ll argue with a stump if it’ll benefit my patients!


38 posted on 07/23/2014 10:30:25 AM PDT by clee1 (We use 43 muscles to frown, 17 to smile, and 2 to pull a trigger. I'm lazy and I'm tired of smiling.)
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