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A General Overview of the Importance of Hospice Item Sets


According to the Affordable Care Act, it is now required that local hospices meet new information reporting requirements that require much more detail than was required in the past. This is called the Hospice Item Set and is often referred to by the acronym HIS. For those who are not familiar with the administrative demands involving hospice care, the Hospice Item Set represents a type of regulatory measure that is designed to make hospice care more transparent for all involved.


The new Hospice Item Set requirements are designed to counter the waves of hospice fraud cases that have been popping up across the United States in recent years. Hospice fraud represents a certain percentage of a larger problem, namely the enormous problem of Medicaid fraud in the United States today, which impacts hospice his services because so many hospice patients' services are paid for through Medicaid. However, even if your hospice services are being paid for by other means, your local hospice service will need to submit a Hospice Item Set for you despite the fact that you are not receiving Medicaid.


In the medical industry, documentation is extremely important. In the case of services in which nurses and other medical care professionals are traveling to the homes of their patients, it can be difficult to reliably document the services that those patients are receiving. It is because of this open or gray area that so many individual care givers have been unscrupulously charging the Medicaid system for services that were not actually administered.


These new regulations, known as the Hospice Item Set, were originally implemented on July 1, 2014. The provisions made by the Affordable Care Act state that each local hospice must submit an HIS for each and every patient receiving services from their program. The Hospice Item Set is required regardless of payer information, location or age of the patient. Since the Hospice Item Set involves the distribution of medical information, even if it happens to be end of life medical services, it is still important that all patients and family members involved be aware of the extent to which medical information is being distributed. For this reason it is very important for anyone who is receiving hospice services or has a loved who is receiving hospice services to read more about it by visiting the website of your local hospice center or the website of the national Hospice head quarters.


The Affordable Care Act goes on to stipulate that any local hospice that fails to comply with these new requirements will end up losing an important percentage of their vital federal funding. Losing this funding could have a negative effect on the care that other patients are able to receive at any local hospice that loses funding. For this reason it is really important that all hospice staff, especially the administrative staff, gain an understanding of all of the new protocols involving documentation and reporting standards involved in these new regulations.