Delta Connect Blog

The Medicare Payment Advisory Commission (MedPAC) met in late December to discuss Medicare payment policy recommendations for inclusion in its forthcoming annual March Report to Congress. The Commission uses a standard framework to assess payment adequacy, including provider access to capital, financial margins, access to care - including numbers and growth in providers, as well as growth in utilization - and quality when making recommendations. In addition to preliminary approval that the Report recommend elimination of the update for hospice payments in Fiscal Year (FY) 2016, Commissioners supported reprinting of previous MedPAC recommendations that have not yet been implemented.

Late Monday, August 4, the Centers for Medicare & Medicaid Services (CMS) issued a final rule governing hospice payment for fiscal year (FY) 2015: Medicare Program; FY 2015 Hospice Wage Index and Payment Rate Update; HospiceQuality Reporting Requirements and Process and Appeals for Part D Payment for Drugs for Beneficiaries Enrolled in Hospice.  PLEASE NOTE: this link will no longer work after publication of the final rule in the Federal Register, which is scheduled for Friday, August 22.  

The rule includes final payment rate information for the forthcoming federal fiscal year.  It also finalizes some key hospice policy changes and reminds hospices that other, previously-announced changes will become effective on October 1, 2014. If hospices have not previously begun to prepare, they are advised to do so now.

On May 23, 2014, a final rule governing Medicare Advantage (MA) and Part D contracts for calendar year (CY) 2015 was published in the Federal Register.  The rule contains two changes in particular that could affect hospice physicians if they prescribe medications that are appropriately charged to patients’ Part D coverage, and these changes are summarized below. 

As part of its program integrity efforts related to Medicare Part D, the Centers for Medicare & Medicaid Services (CMS) has determined that, effective June 1, 2015, Part D plans may no longer cover drugs that are prescribed by physicians or other eligible professionals who are neither enrolled in Medicare nor have validly opted out of Medicare.