MedPAC Finalizes Hospice Payment Recommendations for FY2015
January 29, 2014 03:26 PM
As noted previously in NAHC Report, the Medicare Payment Advisory Commission (MedPAC) met on January 16 and 17 to finalize the recommendations which will be included in its March 2014 Report to Congress. MedPAC affirmed its support for the hospice recommendations discussed at its December 2013 meeting, with one significant change – in December MedPAC supported inclusion of hospice care under the Medicare Advantage (MA) benefit package beginning in 2017. The final recommendation, however, has this change take place in 2016 instead. The acceleration of the effective date was driven by interest on the part of several MedPAC commissioners to see this change take place sooner rather than later.
Following are the hospice recommendations that will be included in the March report:
1. Congress should eliminate the update to the hospice payment rates for fiscal year 2015.
2. Congress should include the Medicare hospice benefit in the Medicare Advantage benefits package beginning 2016.
The transcript for the January meeting, as well as the presentation slides related to hospice payment and Medicare Advantage are available online here:
Hospice payment presentation
Medicare Advantage presentation
As part of the MA presentation on hospice, MedPAC staff provided some additional detail related to how they would see the recommendation being implemented. MedPAC expects that the hospice benefit in its entirety (as required under current law) would be covered, so plans could not pick and choose which services would be provided.
Preauthorization could be part of how the plan approaches hospice coverage, but MedPAC believes that preauthorization for hospice services, given the scope and use of the benefit, would likely be too cumbersome for plans to implement. MedPAC also noted that plans would have the latitude to charge beneficiary cost sharing for hospice.
The National Association for Home Care & Hospice (NAHC) and its affiliated Hospice Association of America (HAA) have had several conversations with representatives of MedPAC during which NAHC/HAA have expressed a number of concerns about inclusion of hospice under MA. NAHC/HAA efforts in this regard will continue with MedPAC and the Congress over the coming months.