Payment Reimbursement and Managed Care

FY 2024 Hospice Payment Rate Update Final Rule Summary

August 15, 2023 1:47 pm

On July 28, 2023, CMS issued a final rule updating the Medicare hospice payment rates, wage index, the cap amount and the quality reporting requirements for federal fiscal year (FY) 2024. It also summarizes comments CMS received on hospice utilization trends, the provision of higher levels of hospice care, spending patterns for non-hospice services provided during the election of the hospice benefit, and ways to examine health equity, among other topics. This rule also codifies the Hospital Quality Reporting Program data submission threshold, discusses the Hospice Outcomes and Patient Evaluation tool, and provides an update on future quality measures development and health equity efforts. In addition, the rule finalizes that physicians who order or certify hospice services for Medicare beneficiaries must be enrolled in Medicare or validly opted-out as a prerequisite for payment for the specific hospice period of care. In response to concerns raised by commenters. CMS will not implement or enforce this requirement until May 1, 2024, to give physicians more time. CMS estimates that the overall impact of the proposed rule will be an increase of $780 million (3.1 percent) in Medicare payments to hospices during FY 2024.

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