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Volume 24.08

Yesterday, Congressman Earl Blumenauer released a discussion draft of legislation that would, if enacted, substantially modify hospice enrollment, compliance, and Medicare payments.

We will be making an extensive review of the draft that attempts to deal with many issues that have received substantial attention over the past year.  The following are some of the items included in the draft.

  • National moratorium on new providers
  • Increased frequency of surveys
  • Numerous payment reforms including, but not limited to:
    • Rewards for hospice providing more in-person care,
    • Payment increases for high-cost treatments,
    • Addition of in-home respite care,
    • Creation of transitional inpatient respite care benefit,
    • Periodic hospice payment rate updates based on costs,
    • Establishment of a new per-diem reflecting components of care and a new per-visit rate,
    • Creation of an outlier payment,
    • Reduction to routine home care rates when patient resides in a nursing facility setting,
    • Wage adjusting the CAP,
    • Substantial changes to inpatient respite care criteria, and
    • Elimination of all payments to hospices that do not submit quality data.

The draft provides numerous program integrity measures.  Of significant initial interest are:

  • Adding hospice services to the physician self-referral rules (Stark),
  • Extending the 36-month rules relating to transfer of a provider number in the case of a CHOW to sixty (60) months, currently thirty-six (36) months, and
  • Additional physician-related restrictions.

Of course, many additional changes are included in the draft.  We will be providing substantial discussion of the draft and specific provisions as we digest the draft and consider the practical aspects of the provisions.


Yesterday, we announced the dates for our upcoming 2024 Hospice Financial Administration Conference (September 30, 2024 – October 1, 2024) to be held in Phoenix, Arizona.

The changes and proposed changes to Medicare payments, programs, and integrity will be the major theme of our program, including the draft briefly discussed above, and any modifications made to the draft between now and our program dates.  Of course, we will focus on assisting hospices in planning for, complying with, and the accounting and reporting aspects of the potential changes in addition to dealing with current circumstances.

Additional details will be available soon, including registration and instructions for reserving your rooms at the Hilton Phoenix Tapatio Cliffs Resort.  As always, space is limited to ensure the quality of the program and the interactive nature of the program.

We hope to see you or someone from your organization in Phoenix.  Contact us with any questions you may have at conference@healthgroup.com.