2025 Hospice Proposed Rule Released

Numerous factors within the proposed rule can significantly influence your hospice. It’s crucial for hospices to actively engage and submit comments on this proposal before its finalization in August. The comment period spans from now until May 28, 2024. To view the hospice proposed rule, and leave your comments, click here. Ensure your comments are comprehensive and detailed, as your input matters greatly.

PROPOSED PAYMENT ADJUSTMENT

The primary concern for many regarding any proposed rule revolves around its impact on payment rates. In the case of the proposed rule for Hospice in 2025, there’s an increase of 2.6%. This uptick incorporates a 3% Market Basket increase, alongside a -0.4% reduction for productivity. If finalized, this 2.6% boost will also occur in the Hospice Aggregate Cap.

CORE BASED STATISTICAL AREAS

It’s important to note the realignment of many CBSAs (Core Based Statistical Areas), which directly affects the application of your wage index. This adjustment may lead to a negative impact on the wage index for counties nationwide. However, as per the finalized requirement in the 2023 rule, any negative impact cannot exceed 5% in a given year. Even if the realignment results in a reduction greater than 5% for the counties you serve, you’ll only experience a -5% adjustment to your wage index for the upcoming year. Subsequently, in the following years, you can gradually compensate for the difference, with each year’s reduction capped at a maximum of 5%.

HOPE TOOL

Another noteworthy aspect of this proposal is the introduction of the nearly finalized HOPE tool. The HOPE tool, a clinical assessment tool in development for some time, will completely replace the HIS. Unlike the HIS, the HOPE tool will serve as a more comprehensive clinical assessment tool. The proposal suggests its implementation for fiscal year 2025. If enacted on October 1, this change will carry significant implications that we would update you on in a future Monday Minute.

CAHPS HOSPICE SURVEY

Proposed adjustments to the CAHPS Hospice Survey are also on the table. Since their inception, consistent advocacy for survey modifications in both home health and hospice has occurred. Now, there are several proposed changes to the CAHPS Hospice Survey. Click here to learn more about the specifics of these changes.

Additionally, the Special Focus Program, which incorporates survey protocol reviews and algorithmic evaluations based on hospice scores, includes the CAHPS Hospice Survey results. However, the proposed alterations to the CAHPS Hospice Survey, as mentioned in the proposed rule, won’t affect the Special Focus program algorithm.

HOSPICE CONDITIONS OF PARTICIPATION

The proposed rule also highlights certain clarifications regarding the Hospice Conditions of Participation. These revisions focus on distinctions between the Election Statement Language and the Notice of Election. Additionally, there are updates regarding Medical Directors and the utilization of other IDG physicians for certification.

As is evident, this proposed rule for hospice holds immense significance, encompassing numerous elements yet to be fully detailed. We’ll continue to furnish more information as we receive clarification and as the rule progresses towards finalization.

Should you need assistance in understanding or commenting on this proposed rule, HPS is here to help. Please feel free to reach out to us.

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