The fiscal year 2026 proposed hospice rule brings cautious optimism to providers with a projected 2.4% payment increase, though experienced hospices know to factor in the ongoing 2% sequestration when calculating their bottom line. For those who've long struggled with regulatory inconsistencies, this rule delivers welcome clarification on who can certify hospice eligibility, aligning payment regulations with Conditions of Participation after years of confusion.
Most significantly, CMS confirms the HOPE assessment tool will launch on October 1, 2025, as scheduled. Despite earlier speculation about potential delays, hospices should maintain implementation momentum, with CMS planning one final training session this summer. Face-to-face attestation requirements also receive much-needed clarification, potentially reducing one of the top reasons for claim denials.
Beyond operational updates, CMS seeks provider input through several Requests for Information. They're exploring digital quality measurement using FHIR-based reporting, considering new quality measures around well-being and nutrition, and looking for opportunities to streamline regulations and reduce administrative burden. This represents a genuine opportunity for hospice providers to shape future requirements.
The relatively slim 62-page rule contains consequential changes that demand attention. Providers should thoroughly review the complete document, evaluate potential financial impacts, coordinate with state and national associations on comments, and ensure staff education aligns with the clarified regulations. With the comment period closing June 10 and the final rule expected in early August, the time to prepare is now. Let your voice be heard on these important changes that will influence hospice care delivery and reimbursement for years to come.
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