Medicare payments to decrease in 2010
Medicare payments to decrease in 2010
Proposed rule includes other recent requirements
Payments to hospices are estimated to decrease by 1.1% with the update to the Medicare Hospice Wage Index for fiscal year 2010, according to the proposed rule proposed rule published in the Federal Register on April 24, 2009.
The decrease in the hospice payments is the net result of a 3.2 % reduction in payments due to the phase-out of a temporary adjustment used in calculating the wage index, partially offset by an estimated 2.1% increase in the hospital market basket indicator of costs.
The elimination of this adjustment with a two-year phase-out would result in more accurate payments and saves Medicare $2.9 billion over five years, according to a spokesperson with the Centers for Medicare & Medicaid Services (CMS). The phase-out would include a 75% reduction for FY 2010, and it would be eliminated entirely in FY 2011.
The rule also proposes to adopt a Medicare Payment Advisory Commission (MedPAC) recommendation that increases accountability in the physician hospice certification and recertification process. MedPAC found an increasing proportion of hospice patients with stays exceeding 180 days and significant variation in hospice length of stay. Therefore, CMS is proposing that hospice physicians who certify or recertify a beneficiary as terminally ill write a short narrative on the certification form. The narrative would briefly describe the clinical evidence supporting a life expectancy of six months or less.
This proposed rule also solicits comments on several future potential policy changes. To increase accountability in the recertification process, the rule seeks comment on requiring a physician or nurse practitioner to visit every hospice patient after 180 days on the benefit and every benefit period thereafter. This proposed rule also solicits comments on broader payment reform, such as alternate methods to calculate the hospice aggregate cap. Comments are due by June 22, 2009. A link to the proposed rule and accompanying documents are available at: www.gpoaccess.gov/fr. In the "quick search" box, type ["page 18912," "42 CFR Parts 405 and 418" AND hospice]. Select "Medicare Program: Proposed Hospice Wage Index for Fiscal Year."
Payments to hospices are estimated to decrease by 1.1% with the update to the Medicare Hospice Wage Index for fiscal year 2010, according to the proposed rule proposed rule published in the Federal Register on April 24, 2009.Subscribe Now for Access
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