Industry Notes:
You Can Soon Take Your Pick On Hospice Cap Calculation
Published on Thu Mar 24, 2011
You may soon have a choice about how your hospice cap is calculated. So says a CMS Ruling issued April 14. "CMS Rulings are decisions of the Administrator that serve as precedential final opinions and orders and statements of policy and interpretation," the agency notes. CMS has been calculating hospice caps -- and cap overpayment determinations -- by allocating patients entirely to one year (1.0 in a year), CMS Administrator Donald Berwick says in the ruling. But multiple hospices have won court cases challenging that methodology and asking for beneficiaries to be counted proportionately in the years they receive services (for example, 0.5 and 0.5 split between two years). Watch for: Thus, CMS will be issuing a proposed rule that will calculate the cap proportionally, but allow hospices to elect the old all-in-oneyear method, the ruling indicates. The new proportional calculation style would start in 2012. CMS will also "grant relief to [...]