Tightening the Regulatory Knot: Hospice Regulatory and Health Care Legislative Reform Converge on Hospice Clinical Management

Hospices have been implementing various approaches to cope with the increased regulatory scrutiny in the last 3 years, prompted by concern about costs and outcomes. Medicare, through its fiscal intermediaries, has issued increasingly more restrictive local coverage determination (LCD) guidelines for initial and ongoing qualifying criteria. The regulatory focus has been intensified and extended by the 2010 federal health care reform legislation. The article examines how one hospice clinical management team is managing the convergence of the increased regulation and the new federal health care reform requirements.