Medication Relatedness Determinations and Hospice Formularies: Understanding the Essentials
The percentage of Medicare hospice beneficiaries billing Medicare Part D for one or more maintenance drugs was 71.3% in 2013, dropped to 50.8% in 2014 and made an unanticipated rise the subsequent year to 62.7%. To address this increase, CMS is analyzing how maintenance drugs are incorporated into hospice care plans and why these drugs are ‘not being coordinated and paid for by hospice beneficiaries’. CMS maintains that virtually all medications should be covered under the hospice benefit and it is the rare instance that Medicare Part D is billed for medications. At the end of this course, the attendee will recall the recommendation that hospice reports all diagnoses, whether related or unrelated to the terminal prognosis, including mental health disorders and conditions that would affect the plan of care. In addition, hospice covers all related and helpful medication therapy and documents rationale for medication non-coverage determinations.
The percentage of Medicare hospice beneficiaries billing Medicare Part D for one or more maintenance drugs was 71.3% in 2013, dropped to 50.8% in 2014 and made an unanticipated rise the subsequent year to 62.7%. To address this increase, CMS is analyzing how maintenance drugs are incorporated into hospice care plans and why these drugs are ‘not being coordinated and paid for by hospice beneficiaries’. CMS maintains that virtually all medications should be covered under the hospice benefit and it is the rare instance that Medicare Part D is billed for medications. At the end of this course, the attendee will recall the recommendation that hospice reports all diagnoses, whether related or unrelated to the terminal prognosis, including mental health disorders and conditions that would affect the plan of care. In addition, hospice covers all related and helpful medication therapy and documents rationale for medication non-coverage determinations.
American Nurses Credentialing Center
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Nurses will receive 1.00 Nursing Contact Hours after successfully completing this course.
Arkansas State Board of Nursing
Arkansas State Board Of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
District of Columbia Board of Nursing
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Nursing
Florida Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Georgia Board of Nursing
Georgia Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Kansas State Board of Nursing
Kansas State Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Kentucky Board of Nursing
Kentucky Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Michigan Board of Nursing
Michigan Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Mississippi Board of Nursing
Mississippi Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
New Mexico Board of Nursing
New Mexico Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
North Dakota Board of Nursing
North Dakota Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
South Carolina Board of Nursing
South Carolina Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
West Virginia Board of Registered Nursing
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Wyoming Board of Nursing
Wyoming Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Describe Centers for Medicare and Medicaid (CMS) hospice medication coverage regulations
Recognize differences between formularies and hospice coverage
Outline steps in making medication coverage determinations in hospice
Lily Chen is a California Bay Area native who completed her undergraduate education at UC Berkeley and received her Doctor of Pharmacy at Touro University California. She is a passionate pharmacist who has focused her career on making an impact in hospice care. Her commitment to making a difference in people’s lives is what motivates her to give her all every day.
Beyond her professional life, Lily enjoys spending time with her loved ones and taking advantage of the beautiful natural surroundings of the Bay Area through camping and hiking. She is also an active member of her community who volunteers her time to foster animals in need of a home. Lily believes giving back is essential and takes great pride in making a positive impact on the world around her.
The target audience for this course is: Nurses; in the following settings: Hospice.
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.
