CMS Issues Proposed Hospice Payment Rule for 2021

The U.S. Centers for Medicare and Medicaid Services (CMS) on Friday issued its proposed fiscal year (FY) 2021 payment rule for hospice. It includes an update to the wage index, a 2.6 percent payment update, and a change in the payment cap amount. CMS is proposing an aggregate cap value of $30,743.86 for FY 2021, up from the FY 2020 cap of $29,964.78.

The rule is available on an interim basis here and will be posted in the Federal Register on April 15. HCA will be analyzing the proposed rule in greater detail and providing our hospice membership with a detailed memo analyzing the various components.

For FY 2021, CMS is proposing to change the hospice wage index by adopting the most recent Office of Management and Budget statistical area delineations. As a transition measure, CMS will apply a 5 percent cap on any decrease in a geographic area’s wage index value from FY 2020, according to a summary by the National Association for Home Care and Hospice (NAHC).

CMS is also looking to get rid of the Service Intensity Add-on (SIA) budget neutrality factor.

The proposal also outlines changes to the hospice election statement. These changes are in line for implementation on October 1, 2020, along with a model election statement and sample addendum for use in delineating diagnoses and treatments that are unrelated to the hospice terminal diagnosis and related conditions.

Comments are due June 9. Please look for our more detailed analysis in the coming days.