Hospice Center

• The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update the Medicare hospice wage index and Medicare hospice payment rates for fiscal year (FY) 2014.  This proposed rule also provides clarification on diagnosis reporting on hospice claims, proposes changes in the requirements for the hospice quality reporting program, and provides updates on hospice payment reform.  Hospices serving Medicare beneficiaries will see an estimated 1.1 percent increase in their payments for FY 2014. The hospice payment increase is the net result of an estimated 1.8 percent increase in the “hospital market basket” update, which is offset by a 0.7 percent decrease in payments to hospices due to updated wage index data and the fifth year of CMS’ 7-year phase-out of its wage index budget neutrality adjustment factor (BNAF).  A hospice study technical report and a literature review can be found under “Research and Analyses” section of this hospice center page.

• On June 1, 2012, CMS issued CR 7838, entitled “Updates to Caps and Limitations on Hospice Payment”, which moved the cap section of the hospice claims processing manual (IOM 100-04, chapter 11, section 80) to the hospice benefit policy manual (IOM 100-02, chapter 9, new section 90).  CR 7838 also updated the aggregate cap policy to reflect the changes in cap policy which were finalized in the August 4, 2011 Hospice Wage Index Final Rule. 
• The Centers for Medicare & Medicaid Services (CMS) recently issued Change Request (CR) 7675 entitled "Revisions to the Hospice Medicare Summary Notice (MSN)" and CR 7677 entitled "New Hospice Condition Code for Out of Service Area Discharges".   Both CRs will be effective July 1, 2012. 
• Correction to CMS-1355-NR [PDF, 183KB]   (Text Version), "Hospice Wage Index for Fiscal Year 2012", which was published in the Federal Register on May 9, 2011: This Notice of Ruling was corrected to show the correct title, "Hospice Appeals for Review of an Overpayment Determination."  Additionally, this Notice of Ruling was corrected change the effective date of this Notice of Ruling from "April 14, 2011" to "May 9, 2011". (Posted July 22, 2011)
• CMS-1355-R / CMS-1355-NR: Ruling (Issue Date: April 14, 2011; Publication Date: May 9, 2011). CMS issued a Ruling, effective April 14, 2011, establishing CMS policy related to when a hospice challenges the validity of the beneficiary counting methodology in its appeal of an overpayment determination for any hospice cap year ending on or before October 31, 2011. (Posted May, 6 2011)

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