CMS Issues Proposed Rule of FY 2018 Update to Medicare Hospice Reimbursement Rules

A proposed rule has been published by CMS (Centers for Medicare & Medicaid Services) to develop fiscal year (FY) 2018 Medicare hospice reimbursement rates, upgrade the hospice quality programs, and request public input on ways to make better the Medicare hospice program.

The CMS’ proposed rule would increase the hospice rates of FY 2018 by 1 percent (almost $180 million), as mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); CMS assumed that in the MACRA’s absence, the market basket update would have been 2.2 percent. Point out that the annual update is decrease by 2 percentage points for hospices that fail to report required quality data. Centers for Medicare & Medicaid Services (CMS) also propose updating the FY 2018 hospice cap to $28,689.04, an increase of 1 percent.
Several updates has been proposed by CMS to the Hospice CAHPS® Experience of Care Survey measures, and explains the possible use of a new “Hospice Evaluation & Assessment Reporting Tool” (HEART) patient assessment instrument. Moreover, CMS requests comments on potential future hospice quality measure “concepts” dealing potentially avoidable hospice care transitions and access to levels of hospice care. The proposed rule also explains the details of plans of CMS to start public reporting of hospice quality measures on a Hospice Compare Site.
Additionally, Centers for Medicare & Medicaid Services (CMS) solicits comments regarding possible future rulemaking to specify that:

1. The referring physician’s and/or the acute/post-acute care facility’s medical record would serve as the foundation for earlier hospice eligibility determinations; and
2. Documentation of an in-person visit from the hospice Medical Director or the hospice physician member of the interdisciplinary group could be utilized as documentation to support initial hospice eligibility determinations, if required to augment the clinical data from the referring physician/facility’s medical records.

As with other proposed rules of Medicare payment released by the Trump Administration, Centers for Medicare & Medicaid Services (CMS) requests information on ways the organization could “increase quality of care, lower charges, make better the program integrity, and make the healthcare system more efficacious, simple and accessible.” CMS won’t respond to comments in the final rule, but it intends to “actively consider all input as we establish future regulatory proposals or future sub regulatory policy guidance.”
On May 3, 2017, the proposed rule was released. Comments on the proposal will be accepted until the day of June 26, 2017.