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Hospice Center

  • CMS will host an Open Door Forum (ODF) call on Tuesday, April 8, 2014 at 1:00 pm to allow hospices and other interested parties to ask questions of CMS subject matter experts on the “ Part D Payment for Drugs for Beneficiaries Enrolled in Hospice—Final 2014 Guidance [ZIP, 2MB] ” issued on March 10, 2014.
  • The Centers for Medicare & Medicaid Services recently launched an initiative to develop innovative payment systems to improve care options for beneficiaries by allowing greater beneficiary access to comfort and rehabilitative care in Medicare and Medicaid.  The Medicare Care Choices Model provides a new option for Medicare beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS who meet hospice eligibility requirements under the Medicare hospice benefit, to receive palliative care services from certain hospice providers while concurrently receiving services provided by their curative care providers.  The Medicare Care Choices Model will test improvements to certain Medicare beneficiaries’ quality of life while they are receiving both curative and palliative care.  Eligible hospice organizations interested in participating in this model must submit application materials no later than June 19, 2014. For application materials and additional information, please visit the Medicare Care Choices Model web page.
  • CMS has issued a final memorandum on March 10, 2014, entitled, “ Part D Payment for Drugs for Beneficiaries Enrolled in Hospice—Final 2014 Guidance [PDF, 254KB] .”  This memorandum provides final guidance for Part D sponsors and hospices as it relates to payment for drugs for hospice beneficiaries in 2014. CMS recognizes that some outstanding issues still exist, primarily for 2015 and beyond.  For those issues, future rulemaking will be required at which time we will take all commenter submission into consideration. The effective date of this policy clarification will be May 1, 2014.

  • Hospice providers should ensure that their information on the hospice list is current and complete.  Please submit any required changes electronically to PECOS at: .
  • CR 8358 entitled “Additional Data Reporting Requirements for Hospice Claims”  was revised on January 31, 2014 to provide clarifying information and examples in the policy section, and to make technical corrections to remove references to legacy contractors in the Business Requirements Table and Funding sections, and to make technical corrections to the manual text. All other information remains the same.  
  • The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 8416, entitled "Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index, Quality Reporting Program and the Hospice Pricer for FY 2014," which is effective October 1, 2013.
  • The Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare hospice wage index and Medicare hospice payment rates for fiscal year (FY) 2014.  This final rule also provides clarification on diagnosis reporting on hospice claims, finalizes 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 1.0 percent increase in their payments for FY 2014. The hospice payment increase is the net result of an estimated 1.7 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).  
  • On Friday July 26th, CMS issued CR 8358, entitled “Additional Data Reporting Requirements for Hospice Claims,” which will be effective for voluntary reporting as of January 1, 2014, and for required reporting as of April 1, 2014. This CR requires additional claims data reporting for hospices to support hospice payment form as authorized by the Affordable Care Act of 2010, section 3132(a). 

  • 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. 

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