The Centers for Medicare & Medicaid Services (CMS) has proposed a 2.7% increase in Medicare hospice payment rates for fiscal year (FY) 2020, which the agency estimates would result in a $540 million increase in Medicare payments to hospices compared with 2019 levels. The annual update would be reduced by 2 percentage points for hospices that fail to report required quality data. The proposed FY 2020 hospice cap is $29,993.99, compared with the FY 2019 cap amount of $29,205.44.

This proposed rule also would:

  • Rebase the continuous home care, general inpatient care, and inpatient respite care per diem payment rates; to maintain budget neutrality, CMS proposes to reduce routine home care payment amounts.
  • Use the current year’s hospital wage data (rather than data from the prior year) to establish the hospice wage index.
  • Modify the hospice election statement requirements to notify beneficiaries if there are services that the hospice will not cover.
  • Revise various Hospice Quality Reporting Program requirements.

CMS includes within the proposed rule a “Request for Information Regarding the Role of Hospice and Coordination of Care at End-of-Life.” Specifically, CMS solicits comments on the potential incorporation of hospice care outside of the Medicare fee-for-service program, such as in the Medicare Advantage program and through accountable care organizations.

The proposed rule is scheduled to be published in the Federal Register on April 25, 2019. CMS will accept comments on the proposed rule until June 18, 2019.