Home Health & Hospice Week

The end of most years brings a flurry of holiday events, scheduling headaches — and potential reimbursement boosts or drops for Medicare providers via a federal budget package for the following year. This year, the stakes appear to be particularly high for home health and hospice agencies.

At press time, the scope of budget legislation was still in dispute, but at least a minimum effort to avoid a government shutdown was expected — and likely more.

For hospices: “As is often the case with large, year-end spending bills, there are many programs and policies Congress wants to ‘stuff in’ to an omnibus funding package before the close of the year,” the National Association for Home Care & Hospice notes in its member newsletter. “To pay for all these priorities, lawmakers must identify ‘offsets’ to fund them. A significant reduction of the hospice aggregate cap, as has been recommended by [the Medicare Payment Advisory Commission] in the past, is being considered for one such ‘offset,’” the trade group warns.

In this year’s report to Congress issued in March, MedPAC recommended a 20 percent cut to the hospice cap amount, plus a rate freeze for 2023 (see HHHW, Vol. XXXI, No. 10).

Hospices need “to tell Congress that cutting the cap in a major and rushed way is bad policy,” NAHC urges.

While MedPAC claims the cap cut will address hospices that are bad actors, instead the Centers for Medicare & Medicaid Services needs to crack down on the compliance front, industry representatives say.

NAHC, the National Hospice and Palliative Care Organization, LeadingAge, and the National Partnership for Healthcare and Hospice Innovation recently sent CMS Administrator Chiquita Brooks-LaSure a letter urging the agency to take “decisive action to maintain the integrity of the benefit through imposition of temporary moratoria on the admission of new agencies in select areas of the country,” according to the letter.

“We believe that targeted moratoria and similar actions directed toward high-risk providers could serve as a valuable means for blocking or eliminating from the hospice program those who engage in improper, unethical, and potentially illegal activities that harm patients and families and taint the reputation of the broader hospice provider community,” the groups say in the letter.