CMS seeks to automate hospice selection process

The CMS next year will change an enrollment policy that prevented hospices around the country from receiving Medicare reimbursements for beneficaries' end-of-life care.

Starting Jan. 1, the CMS will accept Medicare beneficiaries' hospice-care election statements electronically. Industry members have urged the agency for months to make this change, as hospices currently have to submit paper notices or manually type them into a federal database.

Allowing hospices to upload the notices electronically will reduce, and potentially eliminate, problems with the current process of submitting the election notices, the CMS said in a notice posted Thursday.

In 2014, the CMS required election notices be sent to and accepted by Medicare contractors within five calendar days.

That was a major change from the prior policy, which allowed hospice services to begin being reimbursed on the day the patient elected hospice services, regardless of when the notice was received by Medicare contractors.

The 2014 rulemaking resulted in numerous cases in which typographical errors or incorrect information delayed the notices and pushed them out of the five-day submission and acceptance window. In those cases, hospices would not be paid for their work, even after a corrected form was submitted, according to the National Hospice and Palliative Care Organization.

Last year, the organization conducted a survey of its members and found that providers throughout the country cumulatively lost millions of dollars due to the rule.

Looking at the experience of 400 hospices over a six-month period, it found that providers were not paid for nearly 90,000 days of patient care resulting in lost revenue of more than $14 million due to keying mistakes that led to claims being sent back and thus formally not being accepted in five days.

Hospice spending has grown substantially in recent years. From 2000 to 2015,the last year full data are available, Medicare spending for hospice care increased more than 400%, from $2.9 billion to $15.1 billion, according to the Medicare Payment Advisory Commission.