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Improved Access for Hospice Medication Under Medicare Part D

MedicationIf you or a loved one is in need of hospice care, the last thing you want to worry about is cutting through red tape to get prescriptions filled. Until now Medicare required prior authorization for all prescriptions used by hospice patients — either delaying or denying access to certain medications. However, big changes are coming.

Reuters recently announced that The Centers for Medicare and Medicaid Services (CMS) has changed prescription authorization requirements, giving hospice patients easier access to their medications.

This more lenient approach lifts government regulations requiring prior approval for all hospice medications under the Medicare Part D benefit and now only imposes the prior-authorization rule for four drug categories.

While these four categories of drugs (analgesics, anti-nauseants, laxatives, and anti-anxiety medications) are typically used as comfort measures at the end of life, not curative treatment (as required for coverage by Medicare) the CMS predicts that they will be covered as well when providers describe them as “non-illness related” medication.

Read more about this much-needed lift on prior-authorization regulations and critical medication access for end-of-life care.

Were you or someone you know negatively impacted by Medicare’s prior-authorization requirements? What is your opinion of this new ruling?

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit www.MediGapAdvisors.com.

 

 
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