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.
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.