December 18, 2019
At Turley Hansen & Rosasco, LLP, we try to understand how difficult it is to make end-of-life decisions. We have supported 9/11 survivors and their families since 2001, offering the support, guidance, and comfort needed as they undergo treatments or decide to enter into hospice care.
Please see Phil Alvarez, our Director of 9/11 Outreach and Education, talk about the hospice services his brother Luis received before passing of colon cancer. The World Trade Center Health Program provides a number of end-of-life hospice care and palliative services for eligible 9/11 survivors.
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The following hospice services can be provided when they’re needed to care for a member’s terminal illness and related condition(s):
- Physician services
- Nursing services
- Medical equipment (such as wheelchairs or walkers)
- Medical supplies (such as bandages and catheters)
- Drugs for symptom control or pain relief
- Hospice aide and homemaker services
- Physical and occupational therapy
- Speech-language pathology services
- Medical social services
- Dietary counseling
- Grief and loss counseling for member and family
- Short-term inpatient care (for pain and symptom management)
- Short-term respite care
- Other services needed to manage pain and other symptoms related to the member’s terminal illness, as recommended by the hospice
- If receiving at-home hospice care, a member may receive inpatient respite care in a Medicare-certified facility (such as a hospice inpatient facility, hospital, or nursing home) if their usual caregiver (such as a family member) needs a rest. Members can stay up to five days each time they receive respite care; the member may be provided respite care up to two times per six-month coverage period.
Hospice care services include medical, psychological, and spiritual support for individuals who have chosen end-of-life care, according to the World Trade Center Health Program.
Through the hospice care program, eligible recipients can choose to stay at home in their most comfortable settings, or have the option to go to in-patient facilities, hospitals, or nursing homes. The program also provides support services – such as bereavement counseling – for caregivers and families during the last few weeks and months of their loved one’s care.
In order to be accepted into the hospice care program, Level 2 Prior Authorization (PA2) by the CCE or NPN Clinical Direction is required. It must be specified that the recipient has a life expectancy of six months or less. Recipients must also sign an official statement that they are choosing hospice care over other medical treatment options.
The World Trade Center Health Program provides information on eligibility and care services available through the program.
In order for a member’s hospice care to be eligible for payment by the WTC Health Program, the CCE/NPN must meet and document the following requirements:
- The member must be under the care of a CCE/NPN-affiliated physician;
- The hospice care must be provided by a Medicare-certified hospice program and the CCE/NPN is responsible for ensuring that the hospice program is enrolled as a provider in the WTC Health Program;
- The CCE/NPN network physician must provide a Plan of Care 71 to the CCE or NPN Clinical Director for a Level 2 PA for hospice care, which is given in benefit periods;
- The CCE or NPN Clinical Director shall initially provide a Level 2 PA for a 90-day benefit period. Additional authorization(s) are required if there is a need for subsequent hospice care (in 60-day increments);
- Reauthorizations of Level 2 PAs may be completed up to 15 days before the start of the next benefit period; and
- Clinical case management, including a detailed Plan of Care, for hospice members is required to ensure continuity of care during both the initial and any subsequent benefits periods;
If you are interested in learning more about hospice care services available through the World Trade Center Health Program, please Turley Hansen & Rosasco, LLP today at 1-855-WTC-INFO. We would be glad to try and help you and your family.
Posted under: 9/11 Victim Compensation