Volume 26.13
We previously reported that the state of Texas has begun sending repayment demands to hospices that exceeded the Medicaid aggregate payment limitation (“CAP”) relating to Medicaid populations served.
Upon further research it appears that the following states are supposed to be applying the CAP for Medicaid populations served:
- Texas.
- Arizona.
- Montana.
- Georgia.
We are not aware of any repayment demands issued by any state other than Texas.
All fifty (50) states provide Medicare covered hospice services, which is an optional benefit.
For Medicaid, the hospice aggregate cap is an optional limit states can place on overall payments made to a hospice agency during a fiscal year. While states must require an inpatient cap, the aggregate payment cap is voluntary, though it limits how much a provider can bill over the cap period (October 1 to September 30).
If a state elects to apply the aggregate cap, any payments a hospice receives for its claims, more than the cap limit, are considered overpayments and must be returned. The cap amount per beneficiary for Medicaid typically aligns with the Medicare hospice cap, which is set at $35,361.44.
AGENDA SET FOR 2026 HOSPICE FINANCIAL AND COMPLIANCE MANAGEMENT CONFERENCE
The detailed agenda has been set for the 2026 Hospice Financial and Compliance Management Conference. Changes to the agenda may occur depending on events and circumstances arising before the actual conference dates. The program includes a Q&A panel available for questions on essentially any financial or compliance issue attendees would like discussed.
The 2026 “Hospice Financial & Compliance Management Conference” is now available for registration. Early registration has been overwhelming, and the program is expected to sell out. Program space is limited to enhance the quality and networking opportunities for the attendees. The two-day program is being held at the Paris Las Vegas on October 1-2, 2026.
As always, this annual program offers the most extensive hospice financial coverage available. The integration of finance and compliance is critical for the survival and success of any hospice. This year, compliance and the associated financial risks are critical. The conference program, including registration information, is available here. Discounted room rates are available here or by calling (877) 603-4389. Make certain to inform Paris Las Vegas that you are attending The Health Group program. If you are registered but have not secured your room, you are encouraged to do so at your earliest opportunity. There are many special events occurring in Las Vegas at the same time as our program. See you in Las Vegas.