C-TAC: CMS’ ‘Palliative’ Definition in 2025 Proposed Hospice Rule ‘Misaligned, Problematic’

Efforts to establish potential payment mechanisms for high-acuity palliative services within the Medicare Hospice Benefit will require greater clarity from regulators, according to the Coalition to Transform Advanced Care (C-TAC). The U.S. Centers for Medicare & Medicaid Services’ (CMS) 2025 proposed hospice payment rule contained a request for information (RFI) on the potential implementation of […]

CMS Launches GUIDE Model Demonstration With Strong Showing From Hospice, Palliative Care Participants

The U.S. Centers for Medicare & Medicaid Services’ (CMS) has launched the Guiding an Improved Dementia Experience (GUIDE) payment model with close to 400 participating organizations, including many palliative care providers. The CMS Innovation Center announced the GUIDE demonstration in July 2023. The payment model is designed to improve quality of life for dementia patients […]

CMS Revises Hospice Physician Enrollment Guidance to Avoid ‘Disruptive’ Impacts

The U.S. Centers for Medicare & Medicaid Services (CMS) has updated its guidance on the recently implemented hospice certifying physician Medicare enrollment requirement. The revisions were fueled by mounting concerns that the requirement posed potential compliance issues. The requirement stipulated that physicians who certify hospice services must enroll in or opt out of Medicare by […]

CMS Updates Enhancing Oncology Model for 2025

The U.S Centers for Medicare & Medicaid Services (CMS) has announced a second cohort for its Enhancing Oncology Model payment demonstration, as well as some updates to the program. The goals of the Enhancing Oncology Model (EOM), which went live on July 1, are to improve quality and reduce the cost of cancer care with […]

Congress Seeks Answers from CMS on Hospice Fraud, Quality

Members of Congress are demanding answers from the U.S. Centers for Medicare & Medicaid Services (CMS) on continuing evidence of hospice fraud and quality issues. Reps. Beth Van Duyne (R-Texas) and Earl Blumenaur (D-Ore.) led a coalition of 38 congressional lawmakers who in a letter asked CMS for further information on how the agency intends […]

CMS Delays Start of Hospice Physician Enrollment Requirement

The U.S. Centers for Medicare & Medicaid Services (CMS) has delayed the implementation of hospice certifying physician Medicare enrollment requirements. CMS delayed the date to enroll in or opt out of Medicare until June 3 for physicians who certify hospice services. Stipulated in the 2024 hospice payment rule and part of the Affordable Care Act, […]

Support Mounts for Increased Hospice Accreditor Oversight

Calls are growing louder in support of increased accreditation organization oversight that could help curb fraudulent activity in the hospice space. In a proposed rule released in February the U.S. Centers for Medicare & Medicaid Services (CMS) introduced a number of provisions aimed at addressing conflicts of interest and establishing more consistent standards, processes and […]

How ACO Flex Could Make Hospice ‘Top of Mind’ with Primary Care Providers

Collaborations with participants in the Centers for Medicare & Medicaid Innovation’s (CMMI) Accountable Care Organization (ACO) Primary Care Flex demo could allow hospices to leverage their skill sets to access more patients. Hospices and palliative care providers can come to ACOs by two main avenues. They can become members of those organizations themselves, or they […]

[UPDATED] CMS 2025 Proposed Rule Signals Changes to Quality Measurement, Omits Program Integrity Actions

The 2025 proposed hospice rule is raising some questions along with payment rates. In a proposed rule released yesterday, the U.S. Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% increase in hospice per diems for 2025. The agency also proposed two new quality measures and 2025 implementation of the Hospice Outcome and Patient […]

CMS Proposes 2.6% Pay Raise for Hospices in 2025

The U.S. Centers for Medicare & Medicaid Services (CMS) has issued its 2025 proposed rule for hospice payment, which if finalized would include a 2.6% increase in the per diem base rate. The proposal is a likely signal that CMS will not adopt a recent recommendation by the Medicare Payment Advisory Commission (MedPAC) to freeze […]