NHPCO NewsLine Summer 2018 - 40

Short Takes

FY2019 Hospice Wage Index
Proposed Rule

Advocacy
Opioid Toolkit

On Friday, April 27, 2018 CMS posted the FY2019 Hospice Wage Index
Proposed Rule.

The article below was written by
Fullbright Fellow, Lenka Vanova
who spearheaded the production of
the Opioid Toolkit during her tenure
at NHPCO. Many thanks to her and
all who helped with the creation of
this useful tool.

NHPCO analyzed the proposed rule and published a Regulatory Alert on
April 30, 2018. Some highlights of the proposed rule include:
* Hospice rates will increase by 1.8% for FY2019.
* The cap amount has also increased by the same percentage to
$29,205.44.
* Physician assistants will be able to serve as a hospice patient's attending
physician, effective January 1, 2019. NHPCO has worked in collaboration
with the American Academy of Physician Assistants for their inclusion
in the statute. Hospice patients will have additional choices for their
attending physician once this provision is effective.
* CMS has reduced regulatory burden for hospice providers by allowing
drugs and durable medical equipment to be reported in the aggregate on
the claim form, rather than the extremely burdensome per drug or per
equipment reporting that currently exists. CMS estimates that the
elimination of this burdensome reporting will reduce the number of line
items reported on claims by 21.5 million, in the aggregate.
* There will be no new hospice quality measures in FY2019.
* Data points from the hospice public information, currently available in
the Provider Use File and posted by CMS, will be added to an
"information" section in Hospice Compare, so that Medicare
beneficiaries and their families have information that will assist them in
selecting a hospice that meets their needs.
CMS published a data trend analysis of hospice claims and cost report.
Concerns continue to be raised about the number of patients who did not
receive a skilled visit in the last seven days of life, the number of drugs
paid for by Part D after the patient has elected hospice, and the lack of
completeness in the hospice cost report.
NHPCO provides more detail on this
analysis in the Regulatory Alert available
online.

40

NHPCO NewsLine | Summer 2018

"America finds itself in the midst
of an opioid epidemic."
"Drug addiction and opioid
abuse are ravaging America."
"The misuse of and addiction to
opioids ... is a serious national
crisis that affects public health as
well as social and economic
welfare."
These and other similar lines head
most of the current resources and
articles related to opioids. While all
of society is affected by the opioid
crisis, hospice is hit particularly
hard, for reasons that are tied to
efforts to actually solve the crisis.
Patients in hospice care are typically
in need of opioids to address pain
and other symptoms, such as
shortness of breath. Opioids cannot
be avoided in hospice, yet hospices
must abide by legislation which
aims at diminishing the impact of
the opioid crisis. A number of bills
are moving forward both at the
federal and state level. There are
many facets to the problem and thus
multiple aspects legislation is trying
https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-08773.pdf https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-08773.pdf https://www.nhpco.org/fy2019-hospice-wage-index-proposed-rule
Table of Contents for the Digital Edition of NHPCO NewsLine Summer 2018
