Doctor’s Diary November 20, 2018: Hospice abuse

(Snippets from the frontline)

Hospice abuse

Hospice is end-of-life care, and as a separate governmental paying entity is vital to  Medicare patients seeking relief.

Can anyone really predict how long a patient will live and when they will die?

As a geriatric, palliative care, and hospice physician, the ability to recognize failing  health is honed through experience.  My criteria for hospice admission is whether the patient is physically or psychologically suffering after all reasonable medical options have been exhausted.

Likewise, the Medicare criteria for hospice is a terminal diagnosis where a patient will not live longer than 6 months, certified by two doctors.  This is abused and has become a major source of fraud and corruption.

Hospitals and HMO insurance have placed patients on hospice to relieve themselves of their financial obligations.  Patients are targeted in the hospital, especially the ICU.  As a physician who screened patients for hospice eligibility, I periodically saw doctors abandon the Hippocratic Oath misrepresenting medical information.

Most of my patients have a terminal condition but are not suffering.  When they do, they go on hospice. 

Be aware, sometimes there is a money trail you should scrutinize as you move toward end-of-life care.

Gene Uzawa Dorio, M.D.

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