Hospices to receive 2.5% bump for Medicare patients

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Hospices treating Medicare beneficiaries will see a 2.5% increase in payments for fiscal year 2012, according to a final rule released Friday by the Centers for Medicare & Medicaid Services. They must also begin reporting on the quality of care.

There are lots of “really good things” in the final rule for hospices, Theresa Forster, vice president of hospice programs and policy for the National Association of Home Care & Hospice, told McKnight's.

“There are no huge surprises. It's nice that there is a little bit of a [reimbursement] bump,” she says.

The payments are the net result of a 3% increase in the hospital market basket, offset by a .5% decrease in payments to hospices related to updated wage index data. It is the third year of the agency's seven-year phase-out of a wage index budget neutrality adjustment factor.

As required under the Affordable Care Act, hospices will need to start quality reporting programs. Hospices will be required to collect quality data beginning in October 2012 for submission in 2013. Hospices failing to report quality data in 2013 will have their market basket update reduced by 2% in fiscal year 2014.

This phase-in reporting approach means “it's not a baptism by fire,” Forster said. “They want to get them used to reporting.”

CMS also will change the way it counts hospice patients in 2012 and beyond, calculating the number of Medicare hospice beneficiaries in care for a given year based on the number of days the patient received care in each hospice. It will allow hospice providers who do not want a change in their patient counting method to elect to continue using current practices. Forster says CMS is making a push to educate providers on how the caps will work, which is “a smart way to go.”

In addition, the agency said it strove to clarify the “face-to-face” rule regarding recertification of a hospice patient's status. New rules state that any hospice physician can perform a face-to-face encounter with the hospice patient, regardless of whether the same physician recertifies the terminal illness or writes the recertification narrative.

The final rule will be published in the Federal Register on Aug. 4, along with accompanying documents.
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