There is some good news for hospice providers. Hospice providers will receive a 2.1% Medicare payment rate increase for FY 2017, according to a final rule issued by the Centers for Medicare & Medicaid Services (CMS).
CMS released Part D Payment for Drugs for Beneficiaries Enrolled in Medicare Hospice, a notice that encourages sponsors to place beneficiary-level prior-authorization requirements on only 4 categories of prescription drugs identified in a June 2012 Office of Inspector General (OIG) Report:
CMS is moving forward with the Medicare Care Choices Demonstration. This new model came out of the Affordable Care Act, and will allow Medicare beneficiaries in hospice to receive treatments aimed at helping them improve their medical condition at the same time that they receive palliative care, as well as end of life care.
In December, the Bipartisan Chronic Care Working Group of the Senate Finance Committee issued the Policy Options Document that indicates the group is considering requiring Medicare Advantage (MA) Plans to offer the hospice benefit as part of their package of services. The working group's rationale for considering this change is that the current structure for MA enrollees electing hospice care leads to either a disruption in care or fragmented care delivery.
A Jan. 14, 2015, Office of the Investigator General Report indicates that hospices have financial incentives to target Medicare beneficiaries that reside in assisted living who have certain diagnoses and are likely to have long stays.