Hospice Election Statement Addendum Changes-Addendum Webinar

Video Transcription

Video Summary

The webinar focused on the hospice election statement addendum, a CMS requirement introduced in 2020 to notify beneficiaries of items, services, and drugs determined to be unrelated to the terminal illness and related conditions. Dr. Templeton emphasized that the addendum’s purpose is transparency and program integrity, not simply cost control. She stressed that determining what is unrelated must be a physician-led decision tied to clinical reasoning and documented clearly.<br /><br />A major theme was how hospice agencies should operationalize the process. She explained three layers of medication decision-making: whether a medication is related or unrelated, whether it is medically necessary, and whether a therapeutic interchange or formulary substitute should be offered. She noted that related medications may still be deprescribed if not clinically indicated, and that patients can become financially responsible if they refuse an appropriate formulary alternative.<br /><br />Dr. Templeton advised that relatedness determinations should not be placed in the CTI/physician narrative, but instead in a clear, retrievable, printable location in the EMR, preferably in a physician-authored note. She recommended documenting timely, especially when a change in the plan of care triggers the addendum, which must then be furnished within three days. She also discussed how to communicate with pharmacies, the limited role of ABNs in hospice, and the importance of educating staff to avoid framing decisions as cost-driven rather than clinically driven.<br /><br />Overall, the session urged hospices to build strong physician collaboration, prioritize defensible documentation, and use patient-centered conversations when deprescribing or substituting medications.

Meta Tag

Concept Medicare Hospice Benefit Election Statement Addendum

Concept Relatedness Determination

Concept Related Condition

Concept Unrelated Condition

Concept Medication Coverage

Keywords

hospice election statement addendum

CMS requirement

terminal illness

unrelated services

physician-led decision

clinical documentation

medication relatedness

therapeutic interchange

deprescribing

program integrity

Medicare Hospice Benefit Election Statement Addendum

Relatedness Determination

Related Condition

Unrelated Condition

Medication Coverage