Friday, December 5, 2014

CMS Looking to Seize More Dollars from Hospices Via Cap Calculation

We have been recovering from an extensive Thanksgiving and have not posted an update in the last two weeks.  We should be back on schedule until the Christmas break.  On Wednesday November 12th at the Home Health, Hospice & Durable Medical Equipment Open Door Forum CMS dropped a bomb shell.  They have decided in their infinite wisdom to add sequestration revenue to hospice payment in their revenue calculations.  This would overstate hospice payments in the cap calculation. 

Payments for cap year 2013 will be inflated by approximately 1 percent and payments for cap year 2014 will be inflated by 2 percent.  If you were already over the cap in cap year 2013, you will be over by an additional 1 percent.  If you were under the cap in cap year 2013 by less than 1 percent you may now exceed the cap for that year. 

Remember you did not receive any of the sequestration payments.  CMS is generating funny money to create additional cap over payments which they intend to recover from hospices.  This will definitely end up in court. 

We do not have any instructions from CMS on this new procedure.  We expect CMS to issue      instructions later this month when it provides instructions to complete the hospice cap report for 2014.  Remember beginning for cap year ending October 31, 2014 you must do your own cap calculation.  We will be offering a flat rate service to complete you hospice cap reports.  We will announce the price as soon as CMS come out with the instructions.

We will keep you informed in future updates.