Hospice organization files suit to stop CMS rule
Injunction requested to prevent cuts in Medicare payments
The National Hospice and Palliative Care Organization (NHPCO) has filed a lawsuit to stop a Centers for Medicare and Medicaid Services (CMS) rule that would cut hospice reimbursement rates. The rule will alter wage index rates by phasing out the budget neutrality adjustment factor that was applied to the hospice wage index in 1997.
"It is not unusual for CMS to be sued to prevent implementation of a rule, but this is the first time the hospice industry has taken this step," says Jonathan Keyserling, JD, vice president of public policy and counsel for NHPCO. In addition to requesting an injunction in the lawsuit, NHPCO is also pursuing legislative action to overturn the rule, he adds.
Jon Radulovic, vice president of communications for NHPCO, says, "We understand the need to look at expenditures and evaluate changes to the reimbursement system, but NHPCO and our members believe that the necessary due diligence was not performed before publishing the rule."
Keyserling says, "NHPCO filed suit because the proposed changes to hospice care of this type and magnitude requires substantive supporting evidence, which we do not find in this rule."
If implemented as written, the average hospice reimbursement would be reduced from current levels by more than 4%, Radulovic says. This comes at a time when hospices are dealing with increasing salaries, gasoline costs, and supply expenses, he adds. "Most hospices are operating with a profit margin of 3.4% today, so some will not survive the reduction in reimbursement," he says.
The rule is set to take effect Oct. 1, 2008. "The judge hopes to address this issue by the end of October," says Radulovic. This means that the rule is likely to take effect prior to the judge's review, but legislative efforts also might have an effect on the rule, he adds.
Source
For more information about the National Hospice and Palliative Care Organization's efforts related to the Oct. 1 rule, contact:
- Jonathan Keyserling, JD, Vice President of Public Policy, National Hospice and Palliative Care Organization, 1700 Diagonal Road, Suite 625, Alexandria, VA 22314. Telephone: (703) 837-1500. Fax: (703) 837-1233. E-mail: [email protected].
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