In this rule, CMS proposes to rebase the FY2020 per diem payment rates for Continuous Home Care (CHC), Inpatient Respite Care (IRC), and General Inpatient (GIP) levels of care based on their analysis of claims and cost report data, which shows the Hospice average cost per day of care is greater than Medicare reimbursement. To offset the increases in Medicare payments for these three levels of care, CMS proposes to reduce the Routine Home Care (RHC) level of care rate by -2.71% to maintain overall budget neutrality.

Proposed FY2020 Payment Rates

The anticipated impact on Medicare hospice payments, due to the change in the wage impact methodology would vary by provider characteristics and can be found in Table 11 of the proposed rule. CMS has also posted spreadsheets with hospice specific impacts, which vary based on geographical location to the CMS website here.

Hospice Cap Amount

The proposed hospice cap amount for the FY 2020 cap year will be $29,993.99, which is equal to the FY 2019 cap amount updated by the proposed FY 2020 hospice payment update percentage of 2.7%.

Hospice Election Statement Content and Addition of a Proposed Addendum

To address numerous concerns related to Medicare payments that are made for hospice patients outside of the Medicare Hospice benefit after the patient elects the hospice benefit, CMS is proposing modifications to the hospice patient election statement content requirements and a new addendum (submitted upon patient request) to ensure patients are being adequately informed about the scope of services covered under the Medicare Hospice benefit and whether the patient rights are being fully promoted and protected.