Hospice Update: 2016 Proposed Rule

Hospice providers will be rejoicing, knowing that reimbursement isn’t going down, but up.  For 2016, hospice providers should expect a 1.3% increase from 2015. However, hospice providers will not be so happy with the new payment models.  For routine home care (RHC) the first 60 days will be at a different rate than care provided from day 61 and on.

Providers will also have a new model of payment for the last 7 days of care if CMS get its way.  The Service Intensity Add-On (SIA) payment will only apply to the last 7 days before a patient’s death, if these criteria are met:

  1. Patient discharge reason is death.
  2. Care was provided in a location anywhere but a skilled nursing facility (SNF).
  3. An RN or social worker provided direct patient care on the day that is billed as routine home care.

 

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