Essay added to Medicare hospice referral process

Starting next year, Medicare coverage of hospice care will require physicians to write a "short narrative" describing the patient's clinical condition, under a proposed rule. The requirement, to take effect in fiscal year 2010, comes on top of a planned 1.1% cut in hospice care reimbursement rates, according to the proposed Hospice Wage Index rule announced by CMS. The agency said it was concerned about a rising number of hospice patients who survive longer than six months.