Medicare Compliance & Reimbursement

Community networking, fundraising key to staying in the black If the payment increase offered by Medicare this year is less than hospices would like, it should be an incentive to wean themselves off the Medicare reimbursement stream, one expert says. Hospice rates will see a 3.4 percent increase in fiscal year 2004 - the same rate of increase as 2003 - according to the Centers for Medicare & Medicaid Services' July 3 program memorandum A-03-057. "The rates are about what we thought they would be," says Janet Neigh with the Hospice Association of America. "The 3.4 percent for 2004 is not surprising at all," agrees hospice consultant Rita Burch with Rutherfordton, NC-based Watchman Inc. But also not surprising is the fact that hospices continue to struggle under Medicare's meager reimbursement rates, Burch insists. "Medicare rates have never been adequate to cover the cost of our patients."

Hospices that fail to utilize other, non-Medicare resources are shortchanging themselves and potential patients. Hospices shouldn't "look to Medicare to fully cover costs because they never have and they may never want to pay for this service we provide," Burch maintains. The hospice cap for FY 2004 will be $18,661.29. CMS will publish the revised hospice wage index before the rates' Oct. 1 implementation date, according to the memo. The memo is at www.cms.gov/manuals/pm_trans/A03057.pdf.