Centers for Medicare & Medicaid Services (CMS) Issues Final Hospice Payment Rule for FY2015

[Greg Schneider]

CMS Issues Final Hospice Payment Rule for FY2015

August 3, 2014 12:38 PM

Late Monday, Aug. 3, the Centers for Medicare & Medicaid Services (CMS) issued a final rule ( CMS-1629-F ) to update the Medicare hospice payment rates and wage index for fiscal year (FY) 2016.

The final rule reflects the ongoing efforts of CMS to support beneficiary access to hospice care.  Hospices serving Medicare beneficiaries would see an estimated increase in payments of 1.1 percent ($160 million) for FY 2016. CMS is finalizing two routine home care rates, in a budget-neutral manner, to provide separate payment rates for the first 60 days of care and care beyond 60 days.

In addition to the two routine home care rates, CMS is finalizing a service intensity add-on payment that would help to promote and compensate for the provision of skilled visits at end of life.  These two new policies will be effective beginning on January 1, 2016.

The final rule is scheduled to be published in the Federal Register on 08/06/2015 and available online by clicking here on or after 8/6/2015.

Click on this temporary link for access to the final rule before 8/6/2015.

A copy of the final rule and rates can also be found in the attached files.

FY-2016-Final-Hospice-wage-index-.zip

2015-19033.pdf

[Ray Regan]

Greg,

Volunteers help the hospice agencies meet the 5% Medicaid requirement. Could this increase mean the start of helping out volunteers with gasoline costs?

Ray Regan

[Greg Schneider]

Hi Ray,

CMS does not reimburse hospices for volunteer gasoline costs.  The Medicare law with regard to your question, which remains unchanged, reads:

"Upon the implementation of the hospice benefit, the Congress expected hospices to continue to use volunteer services, though these services are not reimbursed by Medicare (see Section 1861(dd)(2)(E) of the Act and (48 FR 38149))."

Current law allows charities to reimburse volunteers, on a nontaxable basis only, up to the charitable mileage rate of 14 cents per mile. Alternatively, volunteers are permitted to deduct their “out of pocket” expenses incurred in providing donated services — when those expenses are not reimbursed.  Source: Independent Sector

The IRS on December 10, 2014 announced the standard mileage rates used to calculate the deductible costs of operating an automobile for business, medical/moving, and charitable purposes for 2015. The rates are:

• 57.5 cents per mile for business miles driven; down from 56.5 cents
• 23 cents per mile for medical/moving purposes; down from 24 cents
• 14 cents per mile driven in service of charitable organizations (same as 2014)

On another front Congress is thinking of volunteers and has proposed new law:

Legislation from the 113th Congress

In March 2013, Sen. Tom Petri (R-WI) introduced the Charitable Driving Tax Relief Act (H.R. 1212) which allows volunteers for recognized nonprofits to exempt from their taxable income any reimbursements they have received for driving a passenger vehicle as part of their volunteer work. Reimbursement is deductible up to the level of for-profit mileage reimbursement (see Background below), and can only be claimed by drivers working on a volunteer basis. 

The proposed legislation is similar to previously unadopted legislation from Sen. Benjamin Cardin (D-MD), who introduced the Giving Incentives to Volunteers Everywhere (GIVE) Act in 2009, to address the inequities between the charitable rate and those for business and medical/moving purposes. The GIVE Act would have:

1. Exempted from a volunteer’s taxable income any reimbursement by a charity for mileage up to the business rate;
2. Given the Treasury Department authority to change the volunteer mileage deduction rate, which has been fixed in statute at 14 cents per mile since 1997; and
3. Raised the volunteer mileage deduction immediately to the medical/moving rate and ensure it doesn't fall below that rate in the future.

Greg Schneider
Founder & President
Hospice VolunteerAssociation
HCF Creator

[Ray Regan]

Greg,

I don't  think the question was clear. I'm not asking about medicare reimbursement, the question is why profit making hospice agency's don't give a gas allowance to volunteers?

Thanks for your reply.

ray 

[Greg Schneider]

OK. Was just suggesting that Congress has thought about your question...unfortunately the proposed law I mentioned never got enacted.  If a hospice could get reimbursed, your hospice would be more likely to support your volunteers in this way.

Good question Ray.  You should pose that question to your hospice.  If the cost of gasoline is causing your volunteers to stop volunteering, this will eventually impact the ability of the hospice to meet its 5% requirement.

While not all volunteers may need help paying the expenses, maybe you can get help from your hospice for those who do need the help or for volunteers who exceed a specified cost threshold.

Greg