Know this about the Medicare hospice benefit

I. Introduction

Elder law attorneys should have a comprehensive understanding of the Medicare hospice benefit for three reasons. The first is quite simple — everyone dies. The second reason is that hospice is a robust Medicare benefit that gives clients the opportunity to die at home, without pain, surrounded by loved ones. The third reason is that dying patients are extremely vulnerable, and unscrupulous providers exploit this vulnerability. Elder law attorneys must understand this Medicare benefit so that they can take appropriate advocacy steps to prevent or end such abuse if it occurs.

II. Hospice Care

A. Definition

According to the National Hospice and Palliative Care Organization:

Hospice care focuses on quality of life when a cure is no longer possible, or the burdens of treatment outweigh the benefits. Hospice care is not just for cancer or for older people; it is for any serious illness at any age. Hospice care is an interdisciplinary team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s and family/inner circle’s wishes and needs.1

Hospice care, however, has not always been available in the United States.

B. In the Beginning

In the late 1960s, psychiatrist Elisabeth Kübler-Ross wrote On Death and Dying.2 In this seminal work, she argued that dying in the United States had become “medicalized.”3 To illustrate this point, she described the experience of dying in a hospital.

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