CMS proposes hospice payments for FY 2027; increased oversight and reporting

The Centers for Medicare & Medicaid Services April 2 issued a proposed rule that would update hospice payment rates for fiscal year 2027. Overall, CMS proposes a 2.4% net increase to payments compared with FY 2026. This includes a 3.2% market basket update and a 0.8 percentage point cut for productivity. Due to this increase, the hospice payment cap would increase to $36,210. Additionally, CMS has developed a measure it is calling the Service and Spending Variation Index, which scores hospices based on their patient’s relative non-hospice spending in an attempt to identify potential bad actors within the hospice program. CMS seeks feedback on the index and scoring. Further, CMS is proposing to make mandatory the Hospice Election Statement Addendum, which is a list that explains what conditions, items, services or drugs the hospice has determined are not related to the beneficiary’s terminal illness. Finally, CMS is proposing to allow a physician designee, in addition to a hospice medical director, to discharge a patient from hospice, as well as conforming changes to regulatory text relating to the hospice telehealth face-to-face requirements.

For the Hospice Quality Reporting Program, CMS proposes that beginning in FY 2028, the agency would add an icon to the Care Compare website for those hospices that fail to submit complete quality data in accordance with CMS requirements. CMS will accept comments on the proposed rule until June 1, 2026.