Changes Beyond Reimbursement Proposed for Hospice Agencies

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Changes Beyond Reimbursement Proposed for Hospice Agencies

You’ve likely already heard that CMS has proposed a net 1.3% increase in hospice payments for FY 2015, but were you aware of the other proposed changes?

Read on to learn more, but know that your opinion counts and should be heard. Comments on these proposals will be accepted until July 1, 2014.

The “hospice market basket” increase actually is 2.7%; but it’s reduced by 0.7% by mandated reductions and another 0.7% by the next-to-last year of the phase-out of the budget neutrality adjustment factor (BNAF). The result is a net increase of 1.3%.

Other CMS proposals include:

  • Terminal illness and related conditions. CMS is soliciting comments on possible definitions of “terminal illness” and “related conditions” to help clarify the accurate coding of hospice claims.
  • Notice of Election (NOE) and Termination/Revocation Notice. CMS proposes to require the filing of an NOE within three calendar days of a hospice election. Beyond that, the proposal would leave hospice providers liable for services between the hospice election and the date of the NOE filing.
  • Including the attending physician on the Hospice Election form. This proposal would require the hospice to identify the attending physician on the election form that’s signed by the beneficiary.
  • Part D and Hospice. Using comments received on guidance published in December about “Part D Payment for Drugs for Beneficiaries Enrolled in Hospice,” CMS seeks comments on Part D and hospice coordination and appeals processes the agency is considering.
  • Hospice Experience of Care Survey. You should be aware that surveys of informal caregivers will begin in FY 2015. This proposed rule describes and provides background on the survey and outlines participation requirements. CMS plans to launch a website for the hospice survey this summer.
  • Eligibility requirements for new hospices. CMS proposes excluding hospices certified after November 1, 2014, from quality reporting requirements for the FY 2016 payment determination. In future years, hospices certified on or after November 1 would be excluded from payment penalties for quality reporting purposes in the following year.

For many of these proposals, using an agency and hospice software solution such as McKesson Hospice™ can help your agency maintain compliance and help maximize reimbursements through the timely compilation of required documentation.

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