CMS Proposes $180 Million Payment Boost to Hospices Nationwide

Hospices would receive a payment increase of $180 million for fiscal year 2014 under a new proposed rule issued Monday.

The payment boost would translate into a 1.1% increase in federal Medicare payments from the Centers for Medicare & Medicaid Services (CMS), as a result of a 0.7% reduction in wage index changes and a 1.8% increase in per diem payment rates.

The proposed rule clarifies diagnosis on reporting hospice claims regarding the use of non-specific symptom diagnoses, such as “debility” and “adult failure to thrive,” according to the agency’s ICD-9-CM Coding Guidelines.


The rule also proposes changes to the hospice quality reporting program. To meet the quality reporting requirements for the FY 2014 payment determination, CMS finalized the requirement that hospice report two measures—pain management and a structural measure that includes a quality assessment program.

As part of the proposal, CMS includes an adoption of the agency’s Hospice Experience of Care Survey for families and friends of hospice patients. The survey would seek input regarding provider communications with said families and friends, quality of care provided and overall rating of the hospice.

The Hospice Experience of Care Survey is currently undergoing development, according to CMS, and the agency plans to include the final requirements for the survey in its fiscal 2015 rule-making.


Additionally, CMS proposes that hospices contract with CMS-aproved vendors to begin continuous monthly data collections starting April 1, 2015.

While data submissions dates are being developed, CMS expects that data would be submitted quarterly.

Written by Jason Oliva

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