CMS has launched a new Medicare Care Choices Model (Model) to allow Medicare beneficiaries with certain medical conditions to receive palliative care services from selected hospice providers without forgoing curative care services. The initiative will allow CMS to study whether access to curative services results in improved quality of care and patient and family satisfaction, and whether there are any effects on use of curative services and the Medicare hospice benefit.
The Model is expected to cover at least 30,000 Medicare and Medicare/Medicaid dual eligible beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, and HIV/AIDS over a three-year period. CMS will select at least 30 rural and urban hospices to participate in the program, with the hospices to be paid a $400 per-beneficiary/per-month fee to furnish services available under the Medicare hospice benefit for routine home care and inpatient respite levels of care that cannot be separately billed under Medicare Parts A, B, and D. Such services must be available 24/7, 365 calendar days per year. Providers and suppliers furnishing curative services to beneficiaries participating in the Model will be able to continue to bill Medicare for reasonable and necessary services.
Hospices interested in participating in the Model must apply by June 19, 2014. Application materials and additional information, including hospice eligibility criteria, are available here.