The due date to file the Self-Determined
Hospice Aggregate Cap for the Cap Year of 2017 is February 28, 2018. This
due date was established with the 2016
Hospice Wage Index and Payment Rate Update Final Rule ("the
Rule"), which finalized the alignment of the hospice cap accounting year
with the federal fiscal year. The Rule established the 2017 cap year as a
transition year, covering a span of 11 months for Proportional (November 1,
2016 to September 30, 2017), and 12 months and three days for Streamlined
(September 28, 2016 to September 30, 2017). This fiscal year timeframe
applies to both the inpatient cap and the hospice aggregate cap. The
below chart details the new cap year dates set forth by the Rule.
Beneficiary Count and
Payment Dates Cap Year 2017:
Inpatient Cap Calculation: For 2017, CMS will calculate the
percentage of all hospice days that were provided as inpatient days (GIP care
and Respite care) from November 1, 2016 through September 30, 2017.
For 2018, CMS will calculate the percentage of all hospice
days that were provided as inpatient days (GIP care and Respite care) from
October 1, 2017 through September 20, 2017.
2017 Hospice Cap Amount - $28,404.99 Based on 12 months: 2017 cap year is equal to the 2016
cap amount ($27,820.75) updated by the FY 2017 hospice payment update
percentage of 2.1%.
Access to the PS&R:
You should make sure that you have access to CMS' EIDM system so that you will
be able to secure your PS&R data. It is our understanding that Palmetto
will once again provide hospices their PS&R data (likely later in January)
but the other MACs (CGS and NGS) will require that you secure the PS&R data
The following are links
to the latest MAC-specific information related to self-calculation of the
Hospice Aggregate Cap:
We hope you find this information valuable. As always, we are here to help. Please contact us
with any questions about the hospice cap or any other questions you may have.