NAHC Issues Part 2 Of Its “IN FOCUS” Series On Hospice Payment Rule

Posted on Monday, June 1, 2015 2:48 PM

Last month, we reported that NAHC is developing a series of “IN FOCUS” articles that will be published over the coming weeks. Part 2 of the “IN FOCUS” series is focused on the data behind proposed hospice payment reforms and oversight activities. On April 30, 2015, CMS placed on display at the Office of the Federal Register a proposed rule. CMS also posted additional data slides on its Hospice Center web page that included more in-depth information from the findings. The rule contains numerous changes to the hospice policy – the most noteworthy, according to NAHC, is its proposed reforms of the hospice payment system for care delivered at the routine home care (RHC) level. CMS has had hospice payment changes under review since 2010. Earlier indications were that the agency was giving serious consideration to implementation of a tiered payment system for RHC (a tiered payment system is a modified version of the “U” shape payment model for hospice care that was initially proposed by the Medicare Payment Advisory Commission [MedPAC] to Congress in 2009). The preamble to the FY 2016 proposed rule explains that a tiered payment system presented operational and programmatic issues that could lead to a limit reprocessing of hospice claims, among other issues. In recent years, CMS has analyzed and published data that has been gathered as part of its hospice payment reform efforts. This year’s proposed rule contains additional data that highlights areas of hospice practice that raise continuing concerns for CMS. NAHC has developed a summary of informational data that CMS has included in the preamble to the proposed FY 2016 hospice payment regulation to inform providers of important and ongoing data analysis in the area. NAHC expects CMS to post slides on its Hospice Center Web Page that provide additional findings. CMS is also anticipated to continue to monitor data and practice trends in hospice. Click here for more detailed information, including insights from CMS for the payment changes it is proposing and the ongoing oversight and enforcement activities it may pursue.  

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