This Minute covers a quick recap of The Hospice Final Rule released on July 29, 2021, that updates Medicare hospice payments and the aggregate cap amount for FY 2022 in accordance with existing statutory and regulatory requirements.

Hello everyone and welcome to our Monday Minute. Today I want to share with you that the Hospice 2022 Final Rule has been released, and some of the things that have been finalized. Within the Hospice Final Rule, they have finalized the rates for 2022, originally proposed at a 2.3% increase in the rates, they have now been finalized at a 2% increase. It does happen most years that there is a slight difference between what’s actually proposed and what’s finalized. And again, this year, they have proposed a 2.3% increase that wound up at a 2% increase. In addition to that, they also had proposed a couple of other key components, one of those being couple of items that we have technically already been involved in as a result of the Public Health Emergency and the COVID-19 waivers. It has now been finalized and these are technically tweaking the Conditions of Participation with hospice aides. They have finalized, as proposed, that agencies will now be able to do hospice aide competencies through the use of pseudo-patients or simulation. They also have finalized that if during a supervisory visit, the aide has been found with a specific skill deficiency, that the agency will be able to do a competency reevaluation of just the specific deficient item instead of having to do a full-blown competency evaluation of the aid. So very helpful change there for sure.

In addition to that, with the election statement addendum, there were proposed clarifications that have now been finalized as well. A couple of concerns surrounding the timing of the addendum having to be delivered to the patient, originally, understanding that you had to have a signature from the family or caregiver within the timeframe. So, if patient upon election requests the addendum, you were required to provide that within five days, and that remains the same. However, previously, the regulation was that if they requested, even the day after the election or the first day into care, you had to provide it within 72 hours. They have now clarified two things. First of all, if they request it any time, in the first five days of care you would have five calendar days to deliver that addendum to the patient. If they requested any time after the first five days of care, you would now have three calendar days to return it to the patient or get it to the patient instead of 72 hours. So, they changed the language from 72 hours to three calendar days, which does help if you really boil it down to actual hours. In addition to that, they have also clarified that this being a condition of payment, the payment condition being met will be driven by the date that the hospice furnishes the document to the patient or individual requested, instead of being the date the recipient signs it. They have also clarified that if a patient refuses the signature requirement the agency will be obligated to document on the addendum itself, why the patient has refused to sign it. You will not have to document within the medical record why the patient refused, which was technically in the proposal, but they have finalized that you only have to document on the addendum itself why the patient refused to sign it. So, the best news being that we will not be held responsible if the patient or caregiver refuses to sign the document. You just have to make sure that it is very clear the date the document was furnished to the person who requested it.

There are multiple other changes that have also been finalized in this hospice final rule. We have an upcoming HPS Alliance webinar to go through that final rule, please make sure you sign up for that. Thank you all again for participating today for being who you are on the front lines in this public health emergency caring for patients. Make sure you stay connected with your Home Care Associations and the National Association of course, and I hope to see you at a conference really soon. Take care and have a great week!


Links to Reference:

Download The Final Rule from the Federal Register.

For further information, see the Hospice Center Webpage

HPS Alliance Webinar: FY2022 Hospice Final Rule – August 19, 2021