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The Centers for Medicare & Medicaid Services has proposed a 2.4% payment increase for hospice providers for 2027.
This is an estimated increase of $785 million in payments from 2026.
The payment is the result of a proposed 3.2% inpatient hospital market basket percentage increase reduced, as required by law, by a proposed 0.8 percentage point productivity adjustment, CMS said.
Hospices that do not submit the required quality data would see a decrease of 4 percentage points, as required by law, which would result in a 1.6% reduction over the previous year’s payment rate.
Comments on the proposed rule are due by June 1.
Said Linda Couch, SVP Policy, of LeadingAge, a nonprofit community of aging services providers: "Given today's uncertain economic environment, and the increased costs in critical categories including food, energy and wages, the modest 2.4% proposed payment rate boost announced late yesterday by CMS is cause for concern."
CMS proposed payment rule follows a call for new oversight of hospice provider fraud.
Last week, CMS proposed new transparency measures for hospice providers, to "ensure Medicaid hospice benefits are not abused by fraudulent actors."
The agency unveiled a publicly available hospice scoring system based on indicators of potential inappropriate utilization, quality of care and compliance concerns.
In late March, the National Partnership for Healthcare and Hospice Innovation (NPHI), representing nonprofit, safety-net, hospice and advanced illness care providers, called upon CMS to implement a temporary, nationwide moratorium on new hospice provider enrollments due to concern over fraudulent providers exploiting the system.
NPHI said its concerns were over "the unchecked expansion of fraudulent hospice providers and the impact on patients, families, and the integrity of the Medicare program," the organization said in a letter sent on March 25 to CMS Administrator Dr. Mehmet Oz and Deputy Administrator and COO Kim Brandt.
"NPHI urges CMS to implement a temporary, nationwide moratorium on new hospice provider enrollments in response to the continued growth of fraudulent providers in the hospice community," said Tom Koutsoumpas, founder and CEO of NPHI. "These bad actors exploit vulnerable patients, undermine trust, and threaten the integrity of the Medicare hospice benefit."
Email the writer: SMorse@himss.org