The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2022, in accordance with existing statutory and regulatory requirements. This rule rebases the hospice labor shares; clarifies certain aspects of the hospice election statement addendum requirements; finalizes changes to the Hospice Conditions of Participation (CoPs) and Hospice Quality Reporting Program (HQRP); and finalizes a Home Health Quality Reporting Program (HH QRP) policy that becomes effective on October 1, 2021, to prepare for public reporting beginning in January 2022.

Under the final rule, hospice agencies will see a 2% increase ($480 million) in Medicare payment rates. Additionally, the aggregate cap amount, which limits the overall payments per patient that are made to a hospice annually, is $31,297.61 for FY 2022, which is about a 2% increase compared to the FY 2021 cap.

This final rule rebases and revises the labor shares for all four levels of care (routine home care, continuous home care, inpatient respite care, and general inpatient care) using the 2018 Medicare cost report data for freestanding hospices. The labor shares are 66% for routine home care, 75.2% for continuous home care, 61% for inpatient respite care, and 63.5% for general inpatient care.

With regards to the hospice CoPs, CMS is finalizing the use of the pseudo-patient for hospice aide competency training, a waiver that was introduced in response to the COVID-19 Public Health Emergency (PHE). Furthermore, the policy requires hospices to conduct a competency evaluation related to the deficient and related skill(s) noted during a hospice aide supervisory visit. 

The HQRP will contain four quality measures that capture care across the hospice stay, including a new measure called the Hospice Care Index. It will also include the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey Star ratings on Care Compare. The rule also finalizes the claims-based Hospice Visits in the Last Days of Life (HVLDL) measure for public reporting to support patient empowerment and transparency of hospice performance.

Other policies in the final rule include a request for information (RFI) on the closing the health equity gap in the HQRP initiative, RFI on the fast healthcare interoperability resources (FHIR) in support of the HQRP initiative, and the home health quality reporting program. 

Source: U.S. Centers for Medicare & Medicaid Services (CMS)

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