Medicare Clarifies Perspective on six month prognosis

The familiar hospice language for a hospice referral has traditionally been "a medical prognosis that his/her life expectancy is 6 months or less if the illness runs its normal course" (Palmetto 26). Recently, as a part of the Benefits Improvement Act of 2000, legislators revised this wording to send a more supportive message to physicians: "Terminal illness of an individual who elects hospice shall be based on the physician’s or medical director’s clinical judgment regarding the normal course of the individual’s illness" (DHHS Program Memorandum 1/24/01).

In the past physicians verbalized concerns about the difficulty in determining prognosis and many feared repercussions from an inaccurate prognosis resulting in a hospice stay of longer than 6 months. These concerns often delayed or prevented a patient’s access to hospice services. This new language is designed to help physicians feel more comfortable referring patients to hospice early enough in their illness that both the patient and the family can experience the full benefit of hospice. It also emphasizes the fact that patients can receive hospice services for longer than 6 months if they continue to meet the hospice criteria. Hospice of Kitsap County will continue to offer information on this change as it becomes available.