CMS Proposes Updates to the Wage Index and Payment Rates

FY 2015 Proposed Rule for Hospice Care.

Late Friday, May 2nd, CMS published the proposed rule for the wage index and payment rates for the Medicare Hospice Benefit fiscal year (FY) 2015.

HEALTHCAREfirst is currently reviewing the proposed rule for the wage index and payment rates in full and will provide a comprehensive webinar to highlight these items next month, but some of the high level changes proposed include:

  • BNAF phase-out: Implement the sixth year of the seven-year BNAF phase-out.
  • Terminal illness and related conditions: CMS is asking for comments on possible definitions of “terminal illness” and “related conditions.”

Notice of Election and Termination/Revocation Notice:

  • Propose to revise the regulations to require that the NOE be filed within three calendar days after the effective date of hospice election.
  • Propose that when the NOE is filed beyond this three day period, the hospice providers would be liable for the services furnished during the days from the effective date of hospice election to the date of NOE filing.
  • Propose new regulations to require hospices to file a notice of termination/revocation within three calendar days of a beneficiary’s discharge or revocation, unless the hospices have already filed a final claim.
  • Including the attending physician on the Hospice Election form: Propose revising regulations to require hospices to identify the attending physician on the election form signed by the beneficiary.
  • Part D and Hospice: CMS is asking for comments on Part D and hospice coordination and appeals processes that they are considering proposing in the future.

Hospice Experience of Care Survey:

  • Hospice providers are required to begin using a Hospice Experience of Care Survey for informal caregivers of hospice patients surveyed in 2015. The proposed rule provides background and a description of the development of the Hospice Experience of Care Survey, including the model of survey implementation, the survey respondents, eligibility criteria for the sample, and the languages in which the survey is offered. The proposed rule also outlines participation requirements for calendar year (CY) 2015. CMS will be launching a website for the hospice survey in the summer of 2014 (
  • Expedited Hospice cap overpayment recovery: Propose requiring providers to complete their cap determination within 150 days after the cap period and remit any overpayments.
  • Eligibility requirements for new hospices: Propose to permit newly certified hospices receiving notice of their CMS certification number on or after November 1, 2014 to be excluded from the quality reporting requirements for the FY 2016 payment determination and for future years, hospices that receive notification of certification on or after November 1, of the preceding year involved, to be excluded from any payment penalty for quality reporting purposes for the following fiscal year.

Click here for the CMS Fact Sheet.
Click here for the full proposed rule.