Hospices Can Use Telehealth Across All Professional Disciplines

While some hospice care definitely requires in-person visits, providers are able to involve telehealth in the full scope of interdisciplinary services during the novel coronavirus pandemic, the U.S. Centers for Medicare & Medicare Services (CMS) indicated in a conference call.

The agency clarified that social workers, chaplains, nurses, physicians and members of other disciplines involved in hospice can work with patients and families via telehealth, including for bereavement care.

“Hospices may provide any services via telemedicine or audio only as long as the patient is receiving routine home care level of care and those telemedicine services which are audio only services are capable of meeting the patient and caregiver need,” said Jean Moody William, acting director at the Center for Clinical Standards and Quality at CMS. “[The hospices] are really going to be the best judge of that.”

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CMS in recent weeks has announced a series of new flexibilities that allow hospices to perform more functions via telehealth than were previously allowed. The recent $2.2 trillion CARES Act stimulus package, designed to help the economy and essential industries weather the impact of the pandemic, also contains provisions related to hospice telehealth, including permitting practitioners to recertify patients via telemedicine appointments rather than face-to-face encounters. These waivers are temporary for the duration of the COVID-19 national emergency.

While welcoming the new flexibilities, hospices have had questions about the scope of the waiver and exactly which services they were allowed to provide via telehealth

“There are some things where, of course, they are going to require an in-person visit to meet the needs of the patient and some that can be done by telemedicine and basically it is permissible to do that when it is advisable to have a telemedicine visit,” Moody William said.

The agency also clarified that a patient’s signature was still necessary to establish consent to receive hospice care.

“We are still requiring signature to elect the hospice benefit. It’s very important because they need to have the Medicare payment made on their behalf to any other provider. It’s important that patient be fully informed of this,” Hillary Loeffler, director, Division of Home Health & Hospice, at CMS said.

As of Wednesday morning, more than three-quarters of a million people in the United States have been diagnosed with the COVID-10 virus, leading to more than 41,000 deaths in 55 jurisdictions. These numbers likely reflect some underreporting due to the limited availability of tests to confirm suspected cases.