Hospice Cap Changes

Insights Client Alert

The fiscal year (FY) 2016 Hospice Wage Index and Payment Rate Update final rule included a change to align the inpatient and aggregate cap accounting year with the federal fiscal year of September 30 beginning in FY 2017.  This change moves the due date to file a self-determined inpatient and aggregate cap determination from March 31 to February 28 for cap years 2017 and beyond.

The following summarizes FY 2016 to 2018 cap timeframes for counting beneficiaries and payments.

                              _______________Beneficiaries________________ 

Cap Year Streamlined Method Patient-by-Patient
Proportional Method
2016 09/28/15 – 09/27/16 11/01/15 – 10/31/16
2017 09/28/16 – 09/30/17 11/01/16 – 09/30/17
2018 10/01/17 – 09/30/18 10/01/17 – 09/30/18


________________Payments__________________  

Cap Year Streamlined Method Patient-by-Patient
Proportional Method
2016 11/1/15 – 10/31/16 11/01/15 – 10/31/16
2017 11/1/16 – 09/30/17 11/01/16 – 09/30/17
2018 10/01/17 – 09/30/18 10/01/17 – 09/30/18

If you have any questions or would like assistance completing your 2017 Self-Determined Hospice Cap form due February 28, 2018, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494.