MedPAC Issues March 2022 Report to Congress: Medicare Payment Policy

From NHPCO

Summary at a Glance

As previously reported, on March 15, 2022 the Medicare Payment Advisory Commission (MedPAC) released its March 2022 Report to the Congress: Medicare Payment Policy. The hospice chapter provides MedPAC’s analysis of the current state of hospice – beneficiary access to care, quality of care, and Medicare spending and margins. MedPAC found that “the indicators of payment adequacy for hospices are positive” and therefore concluded the chapter with the following recommendations for Congress:

“The Congress should:

  • For fiscal year 2023, the Congress should eliminate the update to the 2022 Medicare base payment rates for hospice and wage adjust and reduce the hospice aggregate cap by 20 percent.
  • The Secretary should require that hospices report telehealth services on Medicare claims.”

MedPAC noted that the rationale for the Commission’s March 2021 cap recommendation is due to aggregate payments being “more than sufficient to cover providers’ costs” and concluded that aggregate payments “should be reduced by wage adjusting and reducing the hospice aggregate cap, an approach that focuses payment reductions on providers with the longest stays and high margins.” NHPCO continues to highlight the unintended consequences of the MedPAC recommendations on beneficiary access and quality of care delivered by hospice providers. NHPCO has been actively engaged with MedPAC staff and Commissioners on these issues and submitted official comments multiple times regarding the potential impact of any cut to aggregate cap. We have specifically expressed concern about the impact on access, quality, and cost containment in rural and underserved areas and have requested that MedPAC revisit the original intent of such a cap and relevance today.

Note: Providers should remember that MedPAC is an advisory body that makes recommendations to Congress. Even with a unanimous vote in favor of any recommendation, including modifications to the hospice aggregate cap, Congress must adopt the necessary legislative changes to put these recommendations into effect