The U.S. Centers for Medicare & Medicaid Services (CMS) late Friday released the 2024 proposed payment rule for hospice providers.
In it, CMS proposed to update hospice payments by 2.8%, which includes a market-basket percentage increase of 3% and a 0.2 percentage point productivity adjustment. The increase would translate to an estimated $720 million swell in hospice payments next year compared to Fiscal Year 2023, according to CMS.
If finalized as written, the rule would also raise the aggregate payment cap to $33,396.55, up from $32,486.92 set for 2023.
CMS in the proposal also addressed regulations around telehealth once the public health emergency ends on May 11.
The agency proposed to continue to allow hospice recertifications via telecommunication avenues for patients receiving routine home care, a waiver that would otherwise expire with the PHE’s end.
“We are proposing regulations text changes related to the provision of telehealth services for routine home care at the expiration of the COVID-19 PHE and for the use of telecommunications technology for the face-to-face encounter conducted by a hospice physician or hospice nurse practitioner for the sole purpose of hospice recertification through December 31, 2024,” the agency stated.
The newly proposed rule also included updates around quality and compliance. CMS proposed to raise the annual payment reduction from 2 to 4 percentage points for hospices who fail to meet quality reporting requirements.
“The proposed FY 2024 rates for hospices that do not submit the required quality data would be updated by the proposed FY 2024 hospice payment update percentage of 2.8% minus 4 percentage points, which results in a -1.2% update,” the agency indicated in an announcement.
The newly proposed rule additionally seeks updates to future quality measures, including the Hospice Outcomes & Patient Evaluation (HOPE) tool, currently in development stages. The tool will replace the Hospice Item Set (HIS) quality reporting system when completed. Other quality-related updates included those around health equity initiatives.
Additionally, the rule proposes that physicians who order or certify hospice services for Medicare beneficiaries must be enrolled in Medicare or validly opted-out as a prerequisite for payment for the hospice period of care in question.
“CMS is looking closely at the hospice industry, as we have increasing concerns about fraud, waste and abuse in this space,” the agency wrote. “While this rule takes initial steps, this is part of a larger effort by CMS to address hospice fraud, waste and abuse that will continue this year.”
The full text of the proposed payment rule for 2024 is available here.
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