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Hospice Final Rule Issued

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final regulation regarding the hospice wage index for the fiscal year (“FY”) 2012 (“Final Rule”). As a result of the Final Rule, a 2.5 percent increase in Medicare payments to hospices serving Medicare patients will be implemented for FY 2012.

In addition, the Final Rule includes key changes to the way CMS counts hospice patients beginning with the 2012 cap accounting year. The change comes in the wake of recent lawsuits successfully challenging the hospice cap calculation methodologies and the CMS-1355-R Ruling. The Final Rule allows for retroactive calculations under the new methodology in some circumstances and permits hospice providers to elect to continue using the current counting method.

The Final Rule also includes revisions to the hospice face-to-face requirement. Under the regulation, the hospice physician who performs the face-to-face encounter would not necessarily be the same physician who certifies the patient’s terminal illness.

Lastly, the Final Rule implements a hospice quality reporting program. The program stems from Section 3004 of the Affordable Care Act. Hospices will be required to begin quality data collection in October 2012 and will need to submit the data in 2013. Hospices have the option of earlier voluntary data collection (beginning in October 2011) and submission (2012), but hospices which fail to report quality data in 2013 will be penalized.

The entire text of the Final Rule may be viewed here.

The attorneys at THE HEALTH LAW PARTNERS can provide legal guidance to hospice organizations regarding a multitude of legal issues. For more information, please contact Abby Pendleton, Esq. or Jessica L. Gustafson, Esq. at (248) 996-8510 or visit the HLP website.

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