Posted April 5, 2023
McKnights Home Care
By: Diane Eastabrook
Provider groups were at odds Monday over the Center for Medicare & Medicaid Services’ proposed hospice payment update.
LeadingAge said CMS’ proposed 2.8% payment update for fiscal year 2024 was skimpy at a time when labor costs and other expenses are rising.
“Our members know the conditions on the ground call for more support,” Mollie Gurian, LeadingAge vice president, home-based and HCBS Policy, told McKnight’s Home Care Daily Pulse. “Workforce costs are higher than they have ever been. A more generous market basket update is needed for our nonprofit, mission-driven members to stay afloat and continue to provide quality care to their communities.”
The increase announced late Friday represents a $720 million increase compared to 2023. The payment update is a result of the 3% market basket percentage increase reduced by a 0.2 percentage point productivity adjustment.
The update also includes efforts to improve the hospice industry on behalf of Medicare beneficiaries. Beginning next year, hospices that fail to meet quality reporting requirements will receive a 4-percentage point reduction to the annual hospice payment update percentage increase for the year. It also proposed physicians who order or certify hospice services for Medicare beneficiaries must be enrolled in Medicare or validly opt-out as a prerequisite for payment for the hospice services.
National Association for Home Care & Hospice President William Dombi called the latter proposed move a good “initial step” to stem fraud, waste and abuse in the industry.
“We should anticipate increased emphasis on program integrity in the hospice program, and NAHC will continue to work with our colleagues at the other national hospice organizations and with CMS and others to ensure that these efforts target problem providers,” Dombi told McKnight’s Home Care Daily.
Provider groups, including NAHC, LeadingAge, the National Hospice and Palliative Care Organization and the National Partnership for Healthcare and Hospice Innovation have jointly called on CMS to provide better of the hospice program. NHPCO Interim CEO Ben Marcantonio told McKnight’s Home Care Daily CMS should have included some of the 34 recommendations the organizations made to CMS improve hospice.
“We welcome the opportunity to comment on key areas of concern, health equity and hospice utilization, both critically important to creating access and curbing fraudulent or abusive behavior,” Marcantonio said.
Last week, the Office of Inspector General also called on CMS to improve oversight of some hospices, ensure that all hospice providers are more transparent to patients’ families and improve billing practices.
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