Home Health & Hospice Week

The up-to-171 hospices that may participate in the Medicare Care Choices Model may receive less than they expected for the beneficiaries they serve under the pilot program.

“The hospices will be paid the full $400 [Per Beneficiary Per Month] for each eligible beneficiary enrolled in the MCCM for 15 or more days and provides at least one service per calendar month and $200 PBPM for each eligible beneficiary enrolled in the MCCM for less than 15 days and provides at least one service in a calendar month, with the exception of the month of discharge which will be paid $400 PBPM,” the Centers for Medicare & Medicaid Services says in CR 9136, updated last month.

However, hospices are not on the hook to cover any of their other costs such as drugs or other medical services. Those can be billed for under the usual Medicare benefit, since patients will not have given up curative care, CMS points out.

Up to 71 hospices may begin participating in MCCM on Jan. 1, with 70 more joining in Year 3 of the five-year model, CMS says. More details about MCCM are in the transmittal at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R121DEMO.pdf.