The CMS is proposing that hospices get a 1.3% rate increase from Medicare under a proposed rule issued Thursday.
The proposed payment rule means Medicare would spend $200 million more on hospices in fiscal 2016 than in fiscal 2015. However, the increase is slightly less than the 1.4% raise they received for the current year.
The agency is also using the rule to clarify how to properly document a diagnosis on claims forms. Based on stakeholder comments, the CMS said it is "concerned that some hospices are neither conducting a comprehensive assessment nor updating the plan of care as articulated by the conditions of participation to recognize the conditions that affect an individual's terminal prognosis."
Under the proposed rule, hospices would be required to report all diagnoses identified in initial and comprehensive assessments on hospice claims, whether related or unrelated to the patient's terminal prognosis.
There are more than 4,000 hospices nationwide. The number of Medicare beneficiaries receiving hospice services grew from 513,000 in fiscal 2000 to more than 1.3 million in fiscal 2013. Medicare hospice expenditures, meanwhile, grew from $2.8 billion to an estimated $15.3 billion during that period, the CMS said in the proposed rule.
The disproportionate increase in spending is partly because of an 82% increase in the average lifetime length of stay for beneficiaries, from 54 days in fiscal 2000 to 98.5 days in fiscal 2013.