On August 6, 2018 the Centers for Medicare and Medicaid Services (CMS) published the fiscal year (FY) 2019 Hospice Wage Index and Payment Rate Update final rule. The hospice payment update percentage for FY 2019 is 1.8%.S
The hospice payment update percentage for FY 2019 is based on the inpatient hospital market basket update of 2.9% with the multifactor productivity (MFP) adjustment of -0.8% to yield a final update of 1.8% for hospice providers who submit the required quality data. Those hospice providers that did not submit the required data will receive a -0.2% payment update.
Reporting Drug Data on Claims
The final rule gives hospice providers the ability to submit total, aggregate durable medical equipment (DME) and drug charges on the claim or the option to continue to report infusion pumps and drugs, with corresponding national drug code (NDC) information, on the hospice claim as separate line items. This submission option will no longer be mandatory. Sub-regulatory guidance on this change can be found through change request 10573 and CMS has related educational materials available for review.
Recognition of Physician Assistants as Designated Attending Physicians
Effective for January 1, 2019, CMS is finalizing updates required from the Bipartisan Budget Act of 2018 to expand the definition of attending physician at § 418.3 of the regulations to include physician assistants (PA). They are also finalizing amendments to the regulations at § 418.304 to include the details regarding Medicare payment for designated hospice attending physician services provided by physician assistants. While recognizing comments to allow professionals including PAs to work at the top of their scope, CMS noted that the statute does not allow PAs to perform the face-to-face visit or certify or re-certify terminal illness.
Several updates are made to quality reporting including: