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Hospice

Overview

Hospice

Hospice provides comprehensive and interdisciplinary health care to terminally ill patients, as well as bereavement and support services to the patients’ loved ones. Patients receiving hospice care forgo curative treatments. Hospice care is provided through certified hospice programs, and may be delivered in any patient care setting, but is most often provided in the patient's home.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective hospice health care services.
 

Hospice provides comprehensive and interdisciplinary health care to terminally ill patients, as well as bereavement and support services to the patients’ loved ones. Patients receiving hospice care forgo curative treatments. Hospice care is provided through certified hospice programs, and may be delivered in any patient care setting, but is most often provided in the patient’s home.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective hospice health care services.
 

CHA News Article

MedPAC Issues Recommendations to Congress

At the January meeting, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress increase the rate for hospital inpatient and outpatient prospective payment systems (PPS) by 2 percent in federal fiscal year (FFY) and calendar year (CY) 2020.

CHA News Article

Palliative Care Pilot Program Participants Required to Use New Web-Based Reporting Tool

Patricia Blaisdell, FACHE Debby Rogers, RN, MS, FAEN

In All Facilities Letter 18-57, the California Department of Public Health announces a new web-based data collection tool intended to assist providers that participate in the Palliative Care Pilot Program with annual reporting. Program participants must submit certain information using this tool by Jan. 1 of each program year. 2018 reports were due Jan. 1, 2019, but the online reporting portal will remain open through March 1.

CHA News Article Allison Bradley

CMS Provides Updates for Post-Acute Care Quality Reporting

Patricia Blaisdell, FACHE Allison Bradley

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates for post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines.  

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Updated inpatient rehabilitation facility (IRF) provider preview reports are now available. Providers have until Oct. 8 to review their 2017 quality measure performance data prior to their posting to the IRF Compare website in December. Corrections to the underlying data will not be permitted during this time. However, providers can request CMS review if they believe the data scores displayed are inaccurate. 

Four new quality measures will be reported on IRF Compare: 

  • Assessment-based measures:
    • Application of Percent of Long-Term Care Hospital Patients With an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (NQF #2631)
    • Application of Percent of Residents Experiencing One or More Falls with Major Injury (NQF #0674)
  • Claims-based measures: 
    • Medicare Spending Per Beneficiary
    • Discharge to Community
CHA News Article

CMS Issues FFY 2019 Hospice Wage Index Final Rule

Alyssa Keefe Patricia Blaisdell, FACHE

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule updating the hospice wage index for federal fiscal year (FFY) 2019. CMS finalized a 1.8 percent hospice payment update based on a 2.9 percent inpatient hospital market basket update, reduced by a 0.8 percent productivity adjustment and a 0.3 percentage point adjustment mandated by the Affordable Care Act. The agency estimates the payment update will result in a $340 million increase in hospice payments compared to FFY 2018.

CMS also finalized several changes to the Hospice Quality Reporting Program and, as required by the Bipartisan Budget Act of 2018, expanded the definition of a “hospice attending physician” to include physician assistants in addition to physicians and nurse practitioners. Additional information is available in a CMS fact sheet.

CHA News Article

Post-Acute Care Facilities Notified of Non-Compliance With Quality Reporting

Patricia Blaisdell, FACHE

The Centers for Medicare & Medicaid Services (CMS) has identified inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and hospices that are not in compliance with quality reporting program requirements for calendar year 2017, and sent those facilities notices of non-compliance on July 9. The non-compliance determination will affect the annual increase factor for fiscal year 2019 reimbursement rates.

The notifications were both mailed to the facilities and placed in their Certification and Survey Provider Enhanced Reports folders in the Quality Improvement and Evaluation System. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 p.m. (PT) on Aug. 7. Instructions for requesting a reconsideration are included in the notification letter.  

CHA News Article

Physician-Assisted Death Law Ruled Unconstitutional

Lois Richardson

A Riverside County Superior Court ruled in May that California’s End of Life Option Act violated the state constitution because it was passed during a special legislative session called to work on other issues. The act, which went into effect in 2016, allows terminally ill individuals to obtain a prescription for a drug to end their life if they meet specified requirements.

The judge’s ruling was limited to this procedural issue; he did not rule on the legality of physician-assisted death. The California attorney general appealed the ruling and requested the appellate court to allow the act to be effective while the appeal is pending. The appellate court responded by ordering the parties to submit briefs on the legal issues involved. In addition, the attorney general filed a motion to vacate the trial court judgment, and a hearing on that motion will be held June 29.

In the meantime, the superior court’s ruling declaring the act void and enjoining the state from recognizing it remains in effect throughout the state. CHA will update its members on the status of the case after the hearing later this month.

CHA News Article

Updates Available for Post-Acute Care Quality Reporting   

Patricia Blaisdell, FACHE Alyssa Keefe

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates for post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. The latest updates for inpatient rehabilitation facilities, skilled-nursing facilities, long-term care hospitals, home health and hospice providers are below.

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Inpatient rehabilitation facility (IRF) provider preview reports have been updated and are now available. Providers have until June 30 to review their performance data on quality measures based on data from the fourth quarter of 2016 to the third quarter of 2017, prior to their posting to the IRF Compare website in September. Corrections to the underlying data will not be permitted during this time. However, providers can request a CMS review if they believe their data scores are inaccurate. 

This update of the provider reports includes two additional assessment-based measures and four new claims-based measures, as well as removal of the All-Cause Unplanned Readmission Measure for 30 Days Post-Discharge from Inpatient Rehabilitation Facility measure.  

CHA News Article

CMS Proposes Updates to Payment Rates and Wage Index for Hospices

Patricia Blaisdell, FACHE Alyssa Keefe

On April 27, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update federal fiscal year (FFY) 2019 payment rates and the wage index for hospices.

Under the proposal, CMS estimates payments to hospices would increase by 1.8 percent, or $340 million, compared to FFY 2018. The 1.8 percent update is the result of an estimated 2.9 percent inpatient hospital update, reduced by a 0.8 percent productivity adjustment and a 0.3 percent adjustment mandated by the Affordable Care Act.    

In addition to payment changes, CMS also proposes updates to the Hospice Quality Reporting Program and makes technical changes to regulatory text. Additionally, CMS issues a request for information to solicit comments on ways to achieve interoperability or improved data sharing. 

CHA will provide members with a more detailed summary of the proposed rule in the coming weeks. Comments on the proposed rule are due June 26 by 2 p.m. (PT). A CMS fact sheet is attached.  

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