CMS FY2021 Hospice Final Rule
The Centers for Medicare & Medicaid Services (CMS) FY2021 Hospice Final Rule:
Excerpts from Federal Register 8/4/2020
CMS FY2021 – Effective 10/1/20
- As discussed in the September 14, 2018 Office of Management and Budget (OMB) Bulletin 18-04, the OMB has finalized revisions to the delineations of Metropolitan Statistical Areas (MSAs). Furthermore, changes were made to Core-Based Statistical Area (CBSA) geographic designations, such that some urban counties have become rural, some rural counties have been urban, and some existing CBSAs have been split apart.
- Due to the changes to the OMB delineations, and the resulting changes to the hospice wage index values, CMS has imposed a 5% cap on the overall decrease in a geographic area’s wage index value for FY2021 only for impacted counties.
- Final hospice wage index tables, including a crosswalk between the current and previous OMB delineations, are available through the Internet. They can be found on the CMS Web site at https://www.cms.gov/medicaremedicare-fee-service-paymenthospicehospice-wage-index/fy-2021-final-hospice-wage-index
- For FY2021, the growth rate of the 2013-based hospice market basket in the final rule was 2.4% and has taken into consideration macroeconomic data through June 2020, including the uncertainty due to COVID-19.
- Hospices that fail to submit the required quality data, as applicable, in accordance with Section 1814(i)(5)(A)(i) of the Social Security Act for a fiscal year, will receive a 2.0 percentage point reduction to their market basket update for the fiscal year involved.
- The hospice cap amount for FY2021 will be $30,683.93, which is equal to the FY2020 cap amount updated by the FY2021 hospice payment update percentage of 2.4%.
- No changes to the Hospice Quality Reporting Program were proposed at this time.
- Overall economic impact of the final rule is an estimated increase of $540 million in aggregate payments to hospices during FY2021.
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