CMS Finalizes $340 Million Increase to Hospice Payments in 2019

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule updating the fiscal year 2019 Medicare payment rates for hospice providers.

As the agency proposed in April, hospices will see an increase of $340 million or 1.8% in their payments in fiscal year 2019, an increase of 1% from the last fiscal year. Hospices that fail to meet quality reporting requirements will receive a 2% reduction to their payments.

“We’re still analyzing CMS comments but, as was the case with the proposed rule, it contains no major policy changes, so this is a relatively modest set of changes,” said Theresa Forster, National Association of Home Care & Hospice (NAHC) vice present of hospice policy. “We are very pleased that hospices will get the full 1.8% base payment bump that was projected back in April. This will be a big help to those who have made financial plans based on the projected update.”


The increase is based on an estimated 2.9% inpatient hospital market basket update, reduced by a 0.8% multi-factor productivity adjustment and reduced by a 0.3% adjustment set by the Affordable Care Act (ACA).

The payment system also includes an increased aggregate cap of 1.8% to $29,205.44 versus the $28,689.04 of last year.

The hospice quality reporting requirements have been updated in the final rule, including a review timeframe for data submitted using the Hospice Item Set (HIS), as well as changes to how information will be displayed on Home Health Compare.


The rule also finalized that physician assistants, beginning January 1, 2019, will be recognized as designated hospice attending physicians.

“Inclusion of physician assistants in the definition of attending physician for the Medicare hospice benefit will lead to more flexibility for hospice beneficiaries and providers alike,” a response noted in the finalized rule.

The National Hospice & Palliative Care Organization (NHPCO) also praised this aspect of the final rule.

“NHPCO supports the recognition of the important role played by physician assistants, and we look forward to working with CMS on quality measures that will allow it to focus on value and quality of
patient care,” President and CEO Edo Banach told HHCN.

The finalized rule can be read here.

Written by Kaitlyn Mattson