CMS Finalizes $230 Million Hospice Payment Rate Increase for 2015

Hospices serving Medicare beneficiaries will see an estimated 1.4%, or $230 million, increase in their reimbursements for fiscal year 2015, according to a final rule issued by the Centers for Medicare & Medicaid Services (CMS).

The payment increase would be the net result of a hospice payment update to the hospice per diem rates of 2.1% and a 0.7% decrease in payments to hospices — due to updated wage data and the sixth year of CMS’ seven-year phase-out of its wage index budget neutrality adjustment factor (BNAF).

The finalized rule includes clarifications for terminal illness and related conditions.

Under the Medicare hospice benefit, the hospice physician and the patient’s attending physician, if any, must certify that the patient has a medical prognosis with a life expectancy of six months or less if the terminal illness runs its course.

The agency notes that there has been confusion in the definitions of “terminal illness” and “related conditions,” and has previously solicited comments that it will consider for possible future rule-making.

In addition, the final rule calls for national implementation of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey, — previously known as the Hospice Experience of Care Survey — beginning Jan. 1, 2015, with a dry run from January to March, followed by monthly participation starting on April 1. Hospices will be required to contract with a CMS-approved vendor to conduct the survey on their behalf.

Measures from the survey will be submitted to the National Quality Forum for approval as hospice quality measures.

Access the final rule.

Written by Emily Study

Emily Study