HARRY HUGHES, Governor

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(1)  The patient and his family are considered as a

unit;

(2)  An interdisciplinary team is used to assess the
medical and social needs of the patient, develop an overall
plan of care, and provide coordinated care;

(3)  The patient receives palliative rather than
curative types of treatment; and

(4)  Bereavement follow-up is provided to the family.

It is the intent of this Act to affirmatively establish
Hospice Care Programs in Maryland by providing potential
sources of reimbursement for this type of health care. This
Act requires insurance companies and health maintenance
organizations, both profit and nonprofit, and nonprofit
health service plans to provide health care coverage of
hospice care services, as an option, to individuals and
groups. In addition, this Act authorizes the Maryland
Medical Assistance Program to provide coverage for hospice
care services at its option.

The language of this Act, because of practical
necessity, has limited the scope of reimbursement provided
by insurance companies and the Maryland Medical Assistance
Program. Both sources are limited to reimbursement of
hospice services provided to patients with a 6 month life
expectancy, and who receive services through licensed
hospitals, long term care facilities, home health agencies,
or other legally authorized facilities. Admittedly, the
latter limitation does allow perfunctory latitude for
delivery through facilities which do not presently exist in
Maryland, such as the autonomous free standing hospice care
facility.

In addition to the limitations imposed on both sources
of reimbursement, the provision of this Act that amends the
Maryland Medical Assistance Program only authorizes
reimbursement for hospice care services because of the
prediction of substantial budgetary shortages. It must be
pointed out, however, that preliminary figures presented to
the Hospice Care Reimbursement Study Commission, created by
Joint Resolution No. 29 of 1979, indicated that a hospice
care program, if implemented, should help reduce the
financial shortage projected for the Maryland Medical
Assistance Program due to its potential cost savings.

Although this Act imposes limitations and restrictions
on a Hospice Care Program, for which reimbursement is
available, the ultimate goal of the State of Maryland is to
provide reimbursement coverage and assistance for hospice
care services provided not only by licensed facilities, but
by authorized societies, planning groups, and other persons
as well.