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Volume 21.05

The Centers for Medicare & Medicaid Services (“CMS”) has issued the Proposed RuleMedicare Program; FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements.

The Proposed Rule provides for the following based payment rates (the labor portion is subject to wage-adjustment for determining your respective payment):

Routine home care days 1-60    $    203.81/day
Routine home care days 61+     $    161.02/day
Continuous home care               $    61.07/hour
Inpatient respite care                 $    474.43/day
General inpatient care                $ 1,070.35/day

The labor portion of the rate, subject to adjustment for each hospice is:

Routine home care            64.7%
Continuous home care     74.6%
Inpatient respite care        60.1%
General inpatient care       62.8%

The proposed Hospice CAP per-beneficiary, which is not currently wage adjusted, is proposed at $31,389.66.  Currently the CAP is $30,683.93.

In addition to rate modifications, this rule proposes:

  • Proposed clarification regarding the hospice election statement addendum,
  • Proposes to make permanent selected regulatory blanket waivers for hospice agencies during the COVID-19 Public Health Emergency (PHE) and proposes revisions to the hospice conditions of participation (CoPs),
  • Proposes changes to the Hospice Quality Reporting Program (HQRP),
  • Requests information on advancing to digital quality measurement and the use of Fast Healthcare Interoperability Resources (FHIR),
  • Addresses the White House Executive Order related to health equity in the HQRP and provides updates on advancing the Health Information Exchange, and
  • Proposes changes to the Home Health Quality Reporting Program (HH QRP).

Comments must be submitted by June 7, 2021.