Fed Regist. 2005 Nov 22;70(224):70532-48.
This final rule revises existing regulations that govern coverage and payment for hospice care under the Medicare program. These revisions reflect the statutory changes required by the Balanced Budget Act of 1997 (BBA), the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), and the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA). Additionally, these revisions reflect current policy on the documentation needed to support a certification of terminal illness, admission to Medicare hospice, and a new requirement that allows for discharges from hospice for cause under very limited circumstances. This final rule does not address the requirement for hospice data collection, the changes to the limitation of liability rules, or the changes to the hospice conditions of participation that were included in the BBA. The intent of this final rule is to expand the hospice benefit periods, improve documentation requirements to support certification and recertification of terminal illness, provide guidance on hospice admission procedures, clarify hospice discharge procedures, update coverage and payment requirements, and address the changing needs of beneficiaries, suppliers, and the Medicare program.
本最终规则修订了医疗保险计划下临终关怀服务的覆盖范围和支付的现有规定。这些修订反映了1997年《平衡预算法案》（BBA）、1999年《医疗保险、医疗补助和儿童健康保险计划平衡预算细化法案》（BBRA）以及2000年《医疗保险、医疗补助和儿童健康保险计划福利改善和保护法案》（BIPA）所要求的法定变更。此外，这些修订反映了当前关于支持绝症认证、加入医疗保险临终关怀服务所需文件的政策，以及一项新要求，即允许在非常有限的情况下因合理原因将患者从临终关怀服务中出院。本最终规则未涉及临终关怀数据收集要求、责任限制规则的变更或BBA中包含的临终关怀参与条件的变更。本最终规则的目的是延长临终关怀福利期，完善支持绝症认证和重新认证的文件要求，提供临终关怀入院程序指南，明确临终关怀出院程序，更新覆盖范围和支付要求，并满足受益人、供应商和医疗保险计划不断变化的需求。
