tom hoyer hospice cap

Monday, February 04, 2008

Tom Hoyer & the Hospice Cap

Briefly, I wanted to mention a section of the gaming portion of the article I’ve been writing about that I skipped. It is the section on the Medicare Hospice Cap. (My earlier posts on this article are here and here.)

Mr. Hoyer does not devote a lot of time to the cap, but what he says is priceless. First, let’s review his credintials. He, as a CMS employee, was the person in charge of drafting the original hospice medicare regulations. If anyone on the face of the earth knows what the original purpose of the cap was, it is Tom Hoyer. With that in mind, we’ll look at a couple of quotes.

“The cap was introduced by hospice’s initial advocates as a guarantee that the hospice principle would not exceed the cost of conventional care. At present, it is the only effective check on abuse of the benefit…”

This chops the legs out of the argument that the cap is an antiquated law that was never meant to do what it is doing today. Apparently, the law was inserted by some wise hospice folk who knew that at some point people would try to “game the system”.

Speaking of those arguing for a hospice cap change or moratorium, Mr. Hoyer says:

“There is a current movement to persuade the Congress to raise or eliminate the cap and it is being pursued by clever advocates with high-sounding arguments.”

“The cynical effort to get legislative relief will likely fail. This is a case where the congress can do the right thing by doing nothing, a situation that plays to its classic strength.”

I’ll take him at his word that the push for Medicare Hospice Cap reform will fail, and that’s fine with me.

As I said, he didn’t devote a lot of time on the cap, but I sure think what he said is interesting in the light of everything we are being told by those fighing to change the cap.



Does anybody know where we can get a list of hospices that have exceeded the CAP?