FutureFocus March 28, 2018 Surveys and Compliance 10 Things To Know

Lisa Remington

In this week’s FutureFocus, we discuss an OIG report and its findings that sixty-one percent of Medicare claims for outpatient therapy did not comply. We provide the 10 reasons. Attorney, Elizabeth Hogue, discusses how to contest survey deficiencies. Our Washington Report provides insight into Trump's opioid initiative and responses from NAHC and NHPCO.

Lisa Remington, President, Remington Health Strategy Group

In addition to proposing measures to cut off the flow of illicit drugs; and, to expand opportunities for proven treatments for opioid and other drug addictions, President Trump’s recently announced Opioid Initiative includes these initiatives to reduce demand and over-prescription:

“Implement a Safer Prescribing Plan” to achieve the following objectives:

  • Cut nationwide opioid prescription fills by one-third within three years.
  • Ensure that 75 percent of opioid prescriptions reimbursed by federal healthcare programs are issued using best practices within three years, and 95 percent within five years.
  • Ensure that at least half of all federally-employed healthcare providers adopt best practices for opioid prescribing within two years, with all of them doing so within five years.
  • Leverage federal funding opportunities related to opioids to ensure that States transition to a nationally interoperable Prescription Drug Monitoring Program network.

The administration also intends to launch a nationwide “evidence-based” campaign to raise awareness about the dangers of prescription and illicit opioid use, and other drug use.

And, support research and development of innovative technologies and additional therapies designed to prevent addiction and decrease the use of opioids in pain management. This will include supporting research and development for a vaccine to prevent opioid addiction and non-addictive pain management options.

"Another bill NAHC has mentioned is one by Sen. Rob Portman (R-OH) and others (S2456), to establish a 3-day limit on opioid prescriptions but provides an exemption for cancer treatment, palliative and hospice care."

A number of the administration’s initiatives will require Congress to act, either through new legislation or appropriating additional funds for exiting federal agencies, which means home health and hospice stakeholders have suggestions, and are making them known to Congress.

NAHC Urges Congress

While developing legislation to address the opioid crisis, the National Association for Home Care & Hospice (NAHC) urges that Congress should:

  • Exempt hospice and palliative care patients from prescribing limits for controlled substances;
  • Ensure that efforts by the DEA and other federal agencies to limit domestic production and/or importation of controlled substances do not create shortages that delay appropriate treatment or increase the cost of health care delivery; and,
  • Enact legislation like HR5041 that allows hospice providers to authorize appropriate staff to safely and appropriately destroy controlled medications that are no longer of use to hospice patients.

Another bill NAHC has mentioned is one by Sen. Rob Portman (R-OH) and others (S2456), to establish a 3-day limit on opioid prescriptions but provides an exemption for cancer treatment, palliative and hospice care.

NHPCO Writes Senate Finance Committee

The National Hospice and Palliative Care Organization (NHPCO) was among the organizations writing the Senate Finance Committee, which requested input on actions Congress might take. NHPCO President and CEO Edo Banach wrote:

“As you know, many states are tackling these issues with more stringent prescribing and disposal laws. Fortunately, most state laws setting limits on opioid prescription include exemptions for prescribers treating patients for cancer and for hospice care. NHPCO believes that these exemptions recognize the sensitivity and vulnerability of those suffering advanced illness and at the end of life, and accommodate their needs. Federal policy changes should preserve these exemptions and other considerations.”

For emphasis, NHPCO’s 4-page letter states in boldface type:

“It is imperative that careful consideration be given to the unique needs of patients and families experiencing serious illness and at the end of life, so that we do not unintentionally impair the ability of hospice and palliative care providers to appropriately manage their patients’ pain.

Also, the group called for passage of the pending Palliative Care and Hospice Education and Training Act (S693, HR1676) to improve the training of health professionals in palliative care and establish traineeships for individuals preparing for advanced education nursing degrees, social work degrees, or advanced degrees in physician assistant studies in palliative care.


By: Ronald M. Schwartz, Writer, The Remington Report