CMS Issues Modified RFA for MA Hospice Coverage Demo 

Situation Report | January 11, 2021

While the U.S Centers for Medicare and Medicaid Services (CMS) just recently started its demonstration to test hospice coverage under the Medicare Advantage (MA) package on January 1, 2021, CMS has already released its Request for Applications (RFA) for year two of the model in 2022.

Given that the model does not change substantially during the first two years of operation, the 2022 RFA does not reflect dramatic changes.

It is expected that the model will change significantly beginning in 2023, especially the network requirements. CMS is seeking input from stakeholders regarding its approach to network adequacy.

Also, as part of the 2021 RFA, CMS indicated that participating plans are expected to impose timely data submission requirements similar to those in the Medicare Claims Processing Manual, specifically the timely filing of hospice Notices of Election (NOE). As part of the 2022 RFA, CMS similarly references timely filing of NOEs but also indicates that plans may want to impose timely filing requirement for Notice of Termination/Revocation (NOTR) submissions, as well.

HCA will update our hospice members if CMS provides any additional information.