FACT SHEET
FOR IMMEDIATE RELEASE
August 1, 2018
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
CMS
finalizes updates to the wage index and payment rates for the Medicare
Hospice Benefit for FY 2019
On August 1, the Centers for Medicare &
Medicaid Services (CMS) issued a final rule (CMS-1692-F) that updates
fiscal year (FY) 2019 Medicare payment rates and the wage index for
hospices serving Medicare beneficiaries. In addition, this final rule
updates the hospice quality reporting requirements.
Summary
This final rule updates the hospice wage
index, payment rates, and cap amount for FY 2019. This rule also finalizes
changes to the Hospice Quality Reporting Program (Hospice QRP).
Burden Reduction
This rule enables more efficient use of
Hospice Compare data in the Hospice Quality Reporting Program by no longer
directly displaying the 7 component measures from which a composite measure
is calculated on Hospice Compare. CMS would still provide the public the
ability to view these component measures in a manner that avoids confusion
on Hospice Compare. CMS plans to achieve this by reformatting the display
of the component measures so that they are only viewable in an
expandable/collapsible format under the composite measure itself, thus
allowing users the opportunity to view the component measure scores that
were used to calculate the main composite measure score.
Improving Transparency for Patients
In addition to the updates to the public
reporting of measures on Hospice Compare, this final rule also provides
several updates to the quality reporting program for hospices.
Specifically, the final rule finalizes several procedural policies,
including a review and correction timeframes for data submitted using the
Hospice Item Set (HIS), an extension of the Consumer Assessment of
Healthcare Providers and Systems (CAHPS®) Hospice Survey participation
requirements as well as several public reporting policies and procedures.
Also finalized are specific updates and improvements to Hospice Compare
including the public display of the HIS-based Hospice Comprehensive
Assessment Measure (NQF #3235) and Hospice Visits when Death is Imminent
Measure Pair, reformatting of the public display of the current seven HIS
quality measures, and inclusion of data as shown from the CMS Public Use
Files (PUFs) to help consumers make an informed decision in their selection
of a hospice.
Meaningful Measures
The “Meaningful Measures” initiative is intended to provide a framework
for quality measurement and improvement work at CMS. While this
framework serves to focus on those core issues that are most vital to
providing high-quality care and improving patient outcomes, it also takes
into account opportunities to reduce paperwork and reporting burden on
providers associated with quality measurement.
In this rule, we are finalizing a measure removal factor that takes into
consideration whether the costs and burden associated with a measure
outweighs the benefit of its continued use in the program. Our goal
is to move the program forward in the least costly and burdensome manner
possible, while maintaining meaningful quality measures and continuing to
incentivize improvement in the quality of care provided to patients.
Routine Annual Rate Setting Changes
As finalized, hospices will see a 1.8 percent
($340 million) increase in their payments for FY 2019. The 1.8 percent
hospice payment update percentage for FY 2019 is based on a 2.9 percent
inpatient hospital market basket update, reduced by a 0.8 percentage point
multifactor productivity adjustment and reduced by a 0.3 percentage point
adjustment required by law. Hospices that fail to meet quality reporting
requirements receive a 2.0 percentage point reduction to their payments.
The hospice payment system includes a
statutory aggregate cap. The aggregate cap limits the overall payments made
to a hospice annually. The cap amount for FY 2019 will be $29,205.44 (2018
cap amount of $28,689.04 increased by 1.8 percent).
Hospice Regulations Text Changes Due
to the Bipartisan Budget Act of 2018
Section 51006 of the Bipartisan Budget Act of
2018 amended section 1861(dd)(3)(B) of the Social Security Act such that,
effective January 1, 2019, physician assistants are recognized as attending
physicians for Medicare hospice beneficiaries. This statutory change
expands the definition of a hospice attending physician to include
physician assistants in addition to physicians and nurse
practitioners. We are finalizing changes to the hospice regulations
to reflect that change.
The final rule went on display at the Federal
Register’s Public Inspection Desk and will be available under
“Special Filings,” at https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-16539.pdf
.
For further information, see http://www.cms.gov/Center/Provider-Type/Hospice-Center.html.
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