Home Health & Hospice Week

Starting Oct. 1, your Medicare payments will get a little better -- but just a little.

Hospices' Medicare payment rates will increase 1.8 percent. The 2.6 percent market basket inflation update was offset by two reductions, the Centers for Medicare & Medicaid Services says  in a notice published in the July 22 Federal Register. A 0.8 percent reduction mandated in the health reform law and year two of the hospice benefit's phase-out of the wage index budget neutrality adjustment factor (BNAF) both cut hospices' payment increase.

Hospices also have their own face-to-face encounter requirements, but they are proposed in the home health prospective payment system rule published in the July 23 Federal Register. CMS had to include the provision in the HH PPS rule because it had not planned a hospice proposed rule allowing comments this year.

Two weeks: Hospice patients must have a face-to-face encounter with their certifying physician no more than 15 days prior to recertification, starting with the 180-day recert, CMS says in the rule. The 180 days counts across all hospices a patient has received services from.

A physician narrative associated with the recert "must include an explanation of why the clinical findings of the face-to-face encounter support a life expectancy of 6 months or less," the rule proposes.

Difference: While HHA face-to-face encounters must occur only for SOC patients, hospice encounters are necessary only for recerts.