Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
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This proposed rule updates the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year 2027, resulting in an estimated $785 million increase in payments to hospices. It introduces a Hospice Service and Spending Variation Index (SSVI) based on nine claims-based metrics to help beneficiaries compare providers and support program integrity. The rule proposes making the hospice election statement addendum mandatory for all Medicare beneficiaries at election. It also includes technical changes to discharge rules (allowing physician designees or IDG physicians to discharge patients) and face-to-face encounter telehealth policies (extending through December 31, 2027 with new modifiers and restrictions). Requests for information are issued on community palliative care, a hospice-specific wage index using BLS data, and overlap with Medical Aid in Dying. Updates to the Hospice Quality Reporting Program include adding an icon to the Medicare.gov Compare Tool.
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Key Changes
- Updates hospice wage index and makes application budget neutral for all four levels of care in FY 2027
- Implements FY 2027 hospice payment update percentage and revised payment rates
- Increases hospice aggregate cap amount by the hospice payment update percentage for FY 2027
+ 3 more changes with Pro
Obligations
What this law requires
Hospices must provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election
Hospices must implement updated FY 2027 wage index, payment rates, and aggregate cap amounts as specified in this rule
Hospices must allow physician designees or interdisciplinary group (IDG) physicians, in addition to the hospice medical director, to discharge patients from hospice care
Hospices must comply with face-to-face encounter telehealth policies for hospice recertification extended through December 31, 2027, including the use of modifiers or codes as specified in statute
Hospices must not use telehealth to conduct face-to-face encounters in situations related to moratoriums, enhanced oversight, or specific enrollment status restrictions as defined in section 1866(j) of the Act