I often say that the only thing that stays the same for Medicare providers is that things will change! The proposed Hospice update for 2020 was released April 25, 2020. Included are plans to Rebase the Continuous Home Care, General Inpatient and Inpatient Respite Care Rates. Frankly this is well overdue. The current rates are based on a study of 26 Not-For-Profit-Hospice companies between 1980 and 1983. So many changes have taken place in the industry since those days and in some areas hospices have found it near / or impossible to secure contracts with facilities for GIP and IRC levels of care. As CMS pointed out in this Federal Register that has caused a lot of hospices to operate out of compliance with Conditions of Participation with being equipped to provide four levels of care. The really good news is that PPACA 2010 made provision for Hospice rates to be rebased but required CMS to do so in a budget neutral fashion. The bad news is to keep this budget neutral the rule proposes to reduce the Routine Home Care rate by 2.71%. Considering nearly 98% of hospice days billed are Routine many hospices will feel a hit if this proposal becomes final. The much bigger deal that will affect all hospices is the proposal to require a new Hospice Election Addendum to be made available to beneficiaries (or authorized representatives) and to non-hospice providers upon request. This new proposal is extensive and made to generate more transparency regarding related and unrelated condition determinations made by the Medical Director and IDG Team with patients and non-hospice providers. For more details hospice providers are encouraged to attend our Hospice The Changing Landscape Seminars where we cover regulatory updates, the Hospice Medicare Benefit Policy Manual as well as the Hospice Medicare Billing Manual. For scheduled events see Find Seminars at www.healthcarebesmart.com.

Randy Forrest, Director