Federal Register #CMS1851P

CMS Proposed Rule: FY 2027 Hospice Wage Index, Payment Rate Update, and Quality Reporting Program Changes

This opportunity involves a proposed rule from the Centers for Medicare & Medicaid Services (CMS) to update the Medicare Hospice Program for Fiscal Year 2027. - Government Buyer: - Department of Health and Human Services - Centers for Medicare & Medicaid Services (CMS) - Scope of Rule: - Updates hospice wage index, payment rates (2.4% increase), and aggregate cap amount ($36,210.11) - Applies to all Medicare-certified hospice programs nationwide, including U.S. territories - Key Requirements and Changes: - Mandates the hospice election statement addendum for all Medicare beneficiaries at the time of hospice election, increasing transparency about non-covered services - Introduces the Hospice Service and Spending Variation Index (SSVI) to monitor utilization and spending - Updates the Hospice Quality Reporting Program (HQRP), including a new public reporting icon for non-compliant hospices - Proposes regulatory changes to discharge and face-to-face encounter requirements - Requests information on community palliative care, hospice-specific wage index construction, and the overlap with medical aid in dying (MAID) - Economic Impact: - Estimated $785 million increase in payments to hospices - Notable Details: - No specific OEMs or commercial vendors are named, as this is a regulatory update - Requirements affect all Medicare-certified hospice providers, including those in U.S. territories such as Guam, American Samoa, and the Northern Mariana Islands

Description

This proposed rule by the Centers for Medicare & Medicaid Services (CMS) updates the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year 2027. It includes an analysis of Medicare non-hospice spending during hospice elections and proposes requirements for hospices to provide election statement addenda to Medicare beneficiaries. The rule also proposes changes to discharge regulations, face-to-face encounter regulations, and the Hospice Quality Reporting Program, along with requests for information on community palliative care services, hospice-specific wage index construction, and medical aid in dying. Comments are due by June 1, 2026.

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