Home Health & Hospice Week

Split your claims over Oct. 1 or you'll receive lower payment.

Hospices should enjoy the full inflation update they'll see starting Oct. 1 - it may be their last for a while.
 
Medicare reimbursement rates for hospice will increase 3.3 percent for inflation in fiscal year 2005, the Centers for Medicare & Medicaid Services reveals in July 30 Transmittal No. 264.
 
The update is about what the industry expected, says Janet Neigh with the Hospice Association of America. And it is "about as much as the industry could hope for given the state of the federal budget," says consultant John Mahoney of Summit Business Group in Penfield, NY.
 
"Most will probably feel pretty good about the increase," Mahoney tells Eli. That's despite the fact that Medicare reimbursement is proving scanty in the face of drug costs and rural hospices' increased expenses, he says.
 
But hospices may not see a repeat of the full market basket inflation update next year. The industry is under close scrutiny since hospice utilization has increased significantly in recent years. And the swift growth of for-profit hospices over other types is causing the government, including the Medicare Payment Advisory Commission, to cast a wary eye on the sector (see Eli's HCW, Vol. XIII, No. 23, p. 183).
 
"It will be harder to keep the Congress from cutting into hospice reimbursement" in the future, Neigh worries. "With the MedPAC report, when they go looking for cuts, they may include hospice," she warns.
 
Tip: Hospices would be wise to split their claims when episodes span the FY 2005 start date. Providers that choose not to divide up their claims pre- and post-Oct. 1 will see regional home health intermediaries apply the lower, FY 2004 dates to the entire claim, CMS warns.
 
CMS is correcting its initial statement that the hospice cap amount for the year ending Oct. 31, 2005, is $19,635.67, Neigh tells Eli - the year should be 2004. The wage index will be issued in the Federal Register before the Oct. 1 implementation date.