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CMS Updates Payment Policies for Medicare Hospice Providers

Allison Inserro
Two days after a critical report into the quality and care of hospices caring for Medicare beneficiaries, CMS released a final payment rule for 2019, giving providers an increase of $340 million, and said it will update the information on its Hospice Compare website.
Two days after a critical report into the quality and care of hospices caring for Medicare beneficiaries, CMS released a final payment rule for 2019, giving providers an increase of $340 million, and said it will update the information on its Hospice Compare website. The increase is a 1.8% rise from 2018.

Earlier this week, the Office of Inspector General (OIG) at HHS synthesized 10 years of research into the Medicare Hospice Program and found deficiencies in patient care, inappropriate billing and even fraud.

Some of the changes CMS announced Wednesday were proposed months ago, but they appeared to target some of those issues. For example, effective January 1, 2019, CMS is expanding the definition of a hospice attending physician to include physician assistants, a change made in the Bipartisan Budget Act of 2018.

One of the items mentioned in the OIG report was hospices billing for physician visits that never happened. Another part of the report discussed the lack of information for patients and caregivers to make informed decisions about hospice when searching on the Hospice Compare website.

Added to the website will be the Hospice Item Set (HIS)-based Hospice Comprehensive Assessment Measure and Hospice Visits when Death is Imminent Measure Pair, reformatting of the public display of the current 7 HIS quality measures so that they are easier to understand, and inclusion of additional data  to help make information more publicly transparent.

CMS also finalized the specific collection of data items that support 7 National Quality Forum-endorsed measures for the Hospice Quality Reporting Program.

CMS also finalized several procedural policies, including a review and correction timeframes for data submitted using the HIS, an extension of the Consumer Assessment of Healthcare Providers and Systems Hospice Survey participation requirements as well as several public reporting policies and procedures.

In line with its “Meaningful Measures” initiative, which aims to reduce paperwork and reporting burden on healthcare providers related to quality measurement, CMS said it is removing a measure that takes into consideration whether the costs and burden associated with a measure outweighs the benefit of its continued use in the program. 

However, hospices that fail to meet quality reporting requirements receive a 2 percentage point reduction to their payments. The 2 quality measures they must report are Hospice Visits when Death is Imminent and the Hospice and Palliative Care Composite Process Measure.

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