In accordance with the Patient Protection and Affordable Care Act of 2010 section 3132 requires CMS to collect appropriate data and information to facilitate hospice payment reform. On August 20, 2014, CMS released their final ruling, wage index and payment updates entitled CMS-1609-F 42 CFR Parts 405 and 418.
This final rule will update the hospice payment rates and wage index commencing fiscal year 2015. This final rule provides for a continued "phase-out" of the wage index budget neutrality adjustment factor (BNAF) and provides for payment reform for terminal illness and related conditions inclusive of Part D payments for drugs while under the elected benefit. The effective date of this rule is October 1, 2014.
Key highlights of this final rule include but are not limited to the following:
- Specificity for filing the hospice notice of election and the notice of termination
- Requirements to expedite hospice self-reporting
- New guidance on determining a patient's eligibility
- Update of the hospice wage index with more current date and the BNAF will be reduced by an additional 15% with a completed phase out by 2016
- Updated hospice payment rates for FY 2015 by 2.1%
- New CMS Form 1984-14
Beginning October 1, 2014 and for providers operating as a freestanding, the CMS Form 1984-14 electronic cost report form must be utilized. Cost reports will remain due on or after the last day of the 5th month following a provider's fiscal year end. Key changes in the cost report are detailed as below: