The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1733-P) that updates the Medicare hospice payments for FY 2021, in accordance with existing statutory and regulatory requirements. These updates include routine technical rate-setting updates to the hospice base payment rates and aggregate cap amounts as well as a proposal to adopt the most recent Office of Management and Budget (OMB) statistical area delineations and apply a 5 percent cap on wage index decreases. Finally, this rule will solicit comments on model examples of the modifications to the hospice election statement and the hospice election statement addendum finalized in the FY 2020 hospice final rule for elections on or after October 1, 2020.
The Innovation Center’s hospice benefit component, which tests allowing MA enrollees to access the Medicare hospice benefit through their MA plan beginning January 1, 2021, is the next step in CMS’ multi-pronged strategy to improve care for beneficiaries with serious illness. By fostering partnerships between hospice providers and MA organizations to deliver care for Medicare beneficiaries through the VBID Model, CMS is testing the impact of putting an end to the fragmentation in care and diluted financial responsibility that exists today in order to improve the quality of care that beneficiaries receive. Overall, by reducing fragmentation and coordinating care and financial accountability, CMS is enabling MA organizations to better coordinate palliative and hospice care for enrollees that choose MA. If beneficiaries elect the hospice benefit, they will maintain the broad access they have today to the complete Medicare hospice benefit, as well as additional access to palliative care services, transitional concurrent care services, and hospice-specific supplemental benefits to improve the quality of care beneficiaries receive as well as their quality of life. For additional information, please visit the Model’s website at: https://innovation.cms.gov/initiatives/vbid/. The Request for Applications (RFA) can be found at: https://innovation.cms.gov/Files/x/vbid-hospice-rfa2021.pdf. Registration details for upcoming model overview webinars will be posted on the website.
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