Proposal Would Update Hospice Payment System

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update Medicare fee-for-service (FFS) hospice payment rates, wage index, beneficiary cap amount and quality reporting program requirements for fiscal year (FY) 2023, which begins Oct. 1, 2022.  Key highlights of the proposal include:

  • An increase to the federal per diem rates for hospice providers that comply with quality reporting requirements:
    FY 2022 FY 2023
    Routine Home Care (days 1-60) $203.14 $209.14
    Routine Home Care (days 61+) $160.74 $165.25
    Continuous Home Care $1,462.52 $1,505.61
    Inpatient Respite Care $473.75 $486.88
    General Inpatient Care $1,068.28 $1,098.88
  • A permanent policy to smooth the impact of year-to-year payment reductions related to decreases in the wage index — specifically ensuring that each provider’s wage index would not be less than 95% of its prior year index.
  • An updated aggregate per beneficiary cap of $32,142.65 that limits overall payments per patient that are made to a hospice annually.
  • Updates to the Hospice Quality Reporting Program including an update on the development of a patient assessment instrument titled the Hospice Outcomes and Patient Evaluation tool.
  • Updates on the Consumer Assessment of Healthcare Providers and Systems.
  • A Request for Information related to closing the health equity gap in the Medicare quality programs, including the Hospice Quality Reporting Program.

The CMS is accepting comments on this proposal until May 31. Members with questions should contact Vickie Kunz at the MHA.