CMS Publishes Proposed Rule for Hospice Payments in Fiscal Year 2021

On April 15, 2020, the Centers for Medicare & Medicaid Services (CMS) published the proposed rule for hospice payments in fiscal year (FY) 2021. If finalized, this rule will be effective October 1, 2020.

Proposed Changes to Hospice Payments

CMS has proposed the following updates to the regulations for inflation factors, wage adjustments, and cap amounts for hospice rates in FY 2021.

Other Notable Updates

Hospice Cap Amount

The proposed hospice cap amount for FY 2021 will be $30,743.86, which is an increase from $29,964.78 in FY 2020.

Rural Facility Designations

The Office of Management and Budget (OMB) Bulletin No. 18-04 issued September 14, 2018, will go into effect in 2021. CMS states that it’s important to use the latest OMB delineations to maintain an up-to-date payment system. Changes include the following:

  • 34 counties previously considered urban will be considered rural in FY 2021
  • 47 counties that are currently designated as rural will be considered urban in FY 2021
  • A two-year transition period will be employed, using a 5% cap on decreases in payments due to this methodology change

Economic Impact

The overall economic impact of the proposed FY 2021 changes constitutes a $580 million increase in payments from FY 2020.

Public Comments

Public comments can be submitted through 5:00 p.m. EST on June 9, 2020. When commenting, reference CMS-1733-P. For other options to submit your comments, refer to the proposed rule.

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For more information about the proposed rule, contact your Moss Adams professional.

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