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CMS Releases 2017 Hospice Payment and Policy Changes

08/04/2016

CMS has released “Final Fiscal Year 2017 Payment and Policy Changes for the Medicare Hospice Benefit (CMS-1652-F).” The proposed rule was issued in April 2016 and open for comments. The final rule, says CMS, provides “a summary of each proposed provision, a summary of the public comments received and our responses to them, and the policies we are finalizing for the FY 2017 Hospice Payment Rate Update.”

According to CMS, “This final rule updates the hospice wage index, payment rates, and cap amount for FY 2017. In addition, this rule finalizes changes to the hospice quality reporting program, including the addition of two new quality measures. The final rule also describes a potential future enhanced data collection instrument, as well as plans to publicly display quality measures and other hospice data beginning in calendar year (CY) 2017.”

A key component of the final rule is a 2.1% increase of the hospital market basket payment rate. CMS also announced a change in the cap year, saying that the new cap year will be from October 1, 2016, through September 30, 2017. The cap amount will change to $28,404.99.

One new quality measures focuses on “Hospice Visits When Death is Imminent.” This measure will quantify visits that “hospice staff make to patients and caregivers during the last three and seven days of life.” The second measure, “Hospice and Palliative Care Composite Process Measure, will assess the percentage of hospice patients who received care processes consistent with guidelines. This measure will be based on the seven that are currently being submitted under the Hospice QRP (Pain Screening, Pain Assessment, Dyspnea Screening, Dyspnea Treatment, Patients Treated with an Opioid who are given a Bowel Regimen, Treatment Preferences, and Beliefs/Values Addressed (if desired by patient).”

“The final rule also describes a potential future enhanced data collection instrument as well as plans to publicly display quality measures and other hospice data beginning in the middle of 2017, and includes information regarding the Medicare Care Choices Model (MCCM).” The current Hospice Item Set (HIS) will be enhanced to become a “comprehensive patient assessment instrument, rather than the current chart abstraction tool.” CMS also said that they expect a “2.1 percent ($350 million” increase in Medicare payments for FY2017.” And, says the final rule, “The overall economic impact of this final rule is estimated to be $350 million in increased payments to hospices during FY 2017.”
The final rule will be published in The Federal Register on August 5, and takes effect on October 1. The final rule pre-publication is available now at the first link below. (CMS Final Rule, 7/29, https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-18221.pdf; CMS, 7/29, https://www.cms.gov/Center/Provider-Type/Hospice-Center.html; https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-18221.pdf)