CMS Proposed Rule for Hospice Wage Index Includes Changes to Hospice Cap Formula and Face-to-face Encounter

The Centers for Medicare & Medicaid Services (CMS) recently released a Proposed Rule to update the Hospice Wage Index for Fiscal Year 2012, at 76 Fed. Reg. 26,806 (May 9, 2011). Under the Proposed Rule, CMS provided for a 2.3 percent increase in Medicare reimbursement for hospice providers, but also proposed a new quality reporting system, as required by the Affordable Care Act. Starting in Fiscal Year 2014, hospice providers will be required to submit data on specified quality measures in order to avoid a reduction in their market basket update by 2 percentage points. In addition, the Proposed Rule includes changes to certain regulatory provisions that have been the source of significant controversy within the hospice industry. This article will focus on two notable proposals: (1) changes to the methodology used to calculate the annual aggregate hospice cap limit for providers and (2) modifications of the new face-to-face encounter requirements for hospices.

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