Hospice Final Rule Implementation

Just over the horizon, October and everything pumpkin is approaching.  This means the implementation of the hospice final rule for FY 2023–beginning on October 1^st.  This year’s final rule includes a rate increase of 3.8% for those hospices who submit required quality data.  For those who don’t comply, a 2% payment penalty is assessed to their payment rates.  Hospices should be aware the payment penalty increases to 4% in 2024 based on year 2022 data submissions.  The quality reporting program for hospice was implemented in 2014 and consists of the HIS (Hospice Item Set) and CAHPS (Consumer Assessment of Healthcare Providers and Systems Hospice Survey) components.  Failure to comply with one or both of these requirements triggers the payment penalty reduction for Medicare-certified hospices.  A common error in HIS submission is ensuring the data submission is accepted by CMS’ QIES ASAP.  Hospices should look for the “accepted” confirmation message and then check the Final Validation Report in CASPER to ensure there are no errors.  Maintaining a copy of the Final Validation Report as evidence of successful submission is best practice.