CMS Bucks MedPAC, Proposes $580 Million Hospice Hike

CMS – the Centers for Medicare & Medicaid Services – recently proposed a $580 million increase in fiscal year 2023 hospice payments despite MedPAC’s earlier recommendation of a 20% cut in Medicare’s annual per-patient payment limit for hospice providers.  The increase comes from CMS’ proposed 3.1 percent market basket update, which results in a 2.7 percent increase over previous payments when factoring in a 0.4 percentage productivity cut. 

The proposed 2.7 percent increase provides for an annual payment cap per patient for FY 2023 of $31,142.65. 

CMS also proposed establishing a “permanent mitigation policy” to help lessen the impact on hospice payments from year-to-year due to fluctuations in the hospice wage index.  To do so, CMS proposes to implement a permanent cap to the annual hospice wage index adjustments so payments never decrease more than 5 percent from a prior year. 

The rule also proposed updates to the Hospice Quality Reporting Program (HQRP) that include national beta testing of the Hospice Outcomes and Patient Evaluation (HOPE) tool and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey with Star Ratings.

The proposed rule is a welcome development for hospice providers dealing with 2+ years of COVID while contending with unrelenting audits and recoupments from CMS contractors.  CMS is accepting comments on the proposed rule until May 31, 2022.