CMS issued a Fiscal Year (FY) 2023 Hospice Payment Rate Update final rule to update Medicare hospice payments, wage index, quality reporting programs, and policies. See a summary of key provisions effective October 1, 2022:
- Routine annual rate setting changes resulting in a 3.8% increase in payments for FY 2023
- Permanent 5% cap on negative wage index changes
- Hospice Quality Reporting Program (HQRP) updates, including the new Hospice Outcomes and Patient Evaluation Tool, the Consumer Assessment of Healthcare Providers and Systems hospice survey, quality measures for FY 2023, and a summary of public comments from the request for information to inform future efforts related to HQRP health equity
Recruitment Announcement – Technical Expert Panel (TEP) for Hospice Special Focus Program (SFP) Development
Provisions in the Consolidated Appropriations Act (CAA) of 2021 direct the Secretary to create a Special Focus Program (SFP) for poor-performing hospice programs, to develop and implement a range of remedies and procedures for appealing determinations, and set out requirements for noncompliant hospice programs. In the CY 2022 HH PPS Final Rule, it was stated that additional collaboration would be sought to further develop the methodology for the SFP through a Technical Expert Panel (TEP).
Abt Associates, under contract with CMS, is currently recruiting a wide range of hospice stakeholders, including providers, patient advocates, national and state associations, other hospice staff members, and patients and caregivers for participation in a TEP to contribute feedback and thoughtful input during SFP development.
The objectives of the TEP are to provide input on the SFP algorithm that will be used to identify hospices that have substantially failed to meet applicable Medicare requirements based on identified criteria and measures, to help develop public reporting requirements for the SFP, and to recommend methods to communicate this information to the general public.
The Nomination Form is available at this link: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Spotlight
The nomination form and general questions about the Hospice SFP TEP shall be sent to HospiceSFP@abtassoc.com. Hospice SFP TEP nomination forms must be received by August 12, 2022, to be considered for TEP inclusion.
The Hospice SFP project is under CMS contract number 75FCMC18D0014 and task order number 75FCMC19F0001.
Value-Based Insurance Design (VBID) Model: Hospice Benefit Component
As of January 1, 2021, participating Medicare Advantage Organizations can include the Medicare hospice benefit in their Part A benefits package. Visit the Hospice Benefit Component webpage for more information.
For questions about hospice payment policy, send your inquiry via email to: firstname.lastname@example.org
Beneficiary Notices Initiative
- Hospice Coverage
- Medicare Benefit Policy Manual - Chapter 9 - Coverage of Hospice Services Under Hospital Insurance (PDF)
- Medicare Claims Processing Manual - Chapter 11 - Processing Hospice Claims (PDF)
Participation & Certification
General Provider Information
Hospice Innovation Models
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