CMS has published a proposed rule that would update the Medicare hospice wage index, payment rates, and cap amount for fiscal year (FY) 2017. CMS estimates that the proposed rule would increase overall Medicare payments to hospices by about 2.0%, or $330 million, in FY 2017. This increase reflects a 2.8% proposed market basket update, which would be reduced by a 0.5 percentage point productivity adjustment and an additional 0.3 percentage point adjustment required by the Affordable Care Act. Hospices that do not meet quality reporting requirements would receive a 2.0 percentage point reduction to their payment update, which would result in a 0% update for 2017. The proposed hospice cap amount for 2017 is $28,377.17 (a 2.0% increase over the 2016 cap amount).
CMS also proposes to make changes to the hospice quality reporting program, including adding two new quality measures (Hospice Visits When Death is Imminent, and Hospice and Palliative Care Composite Process Measure). Furthermore, CMS solicits feedback on an enhanced data collection instrument and describes plans to publicly display quality measures and other hospice data on a new "Hospice Compare" web site beginning in the spring/summer of 2017.
CMS also provides an update on hospice trends and discusses plans "to conduct comprehensive, real time monitoring and analysis of hospice claims to help identify program vulnerabilities, as well as potential areas of fraud and abuse." In addition, CMS provides information regarding the previously-announced Medicare Care Choices Model (MCCM), which allows Medicare and dual eligible beneficiaries with certain medical conditions to receive palliative care services from selected hospice providers without forgoing curative care services. The first cohort of MCCM participating hospices began providing services under the model in January 2016; the program is expected to reach 100,000 beneficiaries by 2020.
The proposed rule was published on April 28, 2016. Comments on the proposed rule will be accepted until June 20, 2016.
This article is presented for informational purposes only and is not intended to constitute legal advice.
