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This month, CMS (Centers for Medicare & Medicaid Services) published a final rule to be affecting the Medicare payments to hospice providers.

As CMS proposed in April this year, the final rule will increase payments to hospices by 1.8% or $340 million in the fiscal year 2019. This update is excellent news because this is higher than the previous increase of only 1% for the hospice payments for the fiscal year 2018. The aggregate cap of annual CMS payments to hospices increased by 1.8% also to $29,205.44.

Hospice providers that do not meet the quality reporting requirements as set by the Hospice Quality Reporting Program (HQRP) will now receive a 2% reduction in their CMS payments. These requirements include the two reporting metrics from the Hospice Item Set (HIS) and the Hospice CAHPS® Survey.

This implementation changes the timeline that hospices need to submit data for the HIS to four and a half months following the end of each quarter in a calendar year starting January 1, 2019. There were minor changes to the evaluation categories to CMS’s Hospice Compare program.

The update also will formally recognize physician assistants as designated attending physicians in hospices starting in 2019. This is a welcome change for both hospice providers giving them more staffing flexibility and hospice patients giving them more access to quality caregivers.

Also, the recognition of physician assistants helps fill a growing care need gap of HPM physicians. As a study published this April in the Journal of Pain and Symptom Management noted the supply of specialist HPM physicians is currently not adequate to service the hospice patient population. More worrisome, the “current training capacity is insufficient to keep up with population growth and demand for services.” The foresight of CMS to add physician assistants will be beneficial to address this issue starting in 2019.

CMS has published a Fact Sheet with the highlights or you can read the entire Medicare Program rule update here.


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Colleen M., Social Worker |Brookfield, WIColleen M., Social Worker

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