On Mar. 28, CMS proposed rules on hospice payment rate updates.
CMS issued fact sheet on proposed rule to update FY 2025 hospice payment rate.
Additionally, proposed to adopt the most recent OMB statistical area delineations.
Also, provided clarifying technical updates for hospice conditions of participation.
Hospice Payment Policies
Adopted the most recent OMB statistical area delineations, which revised the existing core-based statistical areas based on data collected during the 2020 Decennial Census.
Hospices affected by the change to their geographic wage index will be eligible for applying a 5% cap on any decrease to the wage index from the prior year.
Solicited comments from the public related to the potential implementation of a separate payment mechanism to account for high-intensity palliative care services.
Annual Rate Setting Changes
FY 2025 hospice payment update percentage is 2.6%; this results from the 3.0% market basket percentage increase reduced by a 0.4% point productivity adjustment.
Proposed FY 2025 rates for hospices that do not submit quality data would be updated by proposed payment update % of 2.6% minus 4% points, results in -1.4% update.
Additionally, the hospice payment update includes a statutory aggregate cap that limits the overall payments per patient that may be made to a hospice annually.
Proposed hospice cap amount for the 2025 fiscal year is $34,364.85 (FY 2024 cap amount of $33,494.01 increased by the FY 2025 hospice payment update % of 2.6%).
Hospice Quality Reporting Program
Proposes Hospice Quality Reporting Program (HQRP) measures be collected through a new collection instrument, the Hospice Outcomes and Patient Evaluation (HOPE).
Issued 2 HOPE-based measures and set planned trajectory for further development.
Requested information re potential social determinants of health (SDOH) elements.
Provides updates on health equity, future quality measures and reporting requirements
Consumer assessment of healthcare providers and systems survey criteria defined.
Consultation
Public comments on the proposals will be accepted until May 28, 2024.
Apr. 2024 Fed Reg Proposal
On Apr. 4, 2024, CMS published proposed rule in federal register, comments May 28.
Jul. 2024 CMS Final Rule Fact Sheet
On Jul. 30, 2024, CMS issued fact sheet reporting on final rule adopted; updated Medicare hospice payment rates and the aggregate cap amount, for fiscal year 2025.
Also, finalized the proposal to adopt the most recent OMB statistical area delineations.
Impacts the hospice wage index and clarifies current policy related to the hospice election statement and notice of election (NOE), as well as, added clarifying language.
Rule summarized comments received on request for information re implementing separate payment mechanism to account for high-intensity palliative care services.
Finalized HQRP measures to be collected through new collection instrument, HOPE.
Also, 2 HOPE-based measures, discussed anticipated trajectory for future refinement.
Summarized comments received on the request for information regarding potential SDOH elements and provided updates on health equity, future quality measures (QMs)
In addition, public reporting requirements; final rule made changes to the Consumer assessment of healthcare providers and systems (CAHPS) hospice survey.
Aug. 2024 HHS Final Rule
On Aug. 6, 2024, HHS published updates on the hospice wage index, payment rates, and aggregate cap amount for FY 2025, adopted new OMB statistical area delineations.
Clarifies current policy re election statement and notice of election, clarifies language re hospice certification, makes technical change to Conditions of Participation (CoPs).
Finalizes changes to the HQRP and summarizes comments re potential implementation of a separate payment mechanism to account for high intensity palliative care services.
Final rule will become effective as of Oct. 1, 2024.
