On Thursday, February 28, 2019, two years after hearing arguments in lead group cases, the Provider Reimbursement Review Board affirmed CMS’ approach to counting sequestered funds as part of provider revenue for hospice cap calculations.
In 2012, to address budget deficits, Congress passed the Budget Control Act, providing for, among other things, a 2% reduction in all payments to Medicare providers. Beginning in fiscal year 2013, acting under Executive Order, CMS began reducing payments to Medicare providers by 2% across the board.
Hospices were no exception. A hospice entitled to payment of $100 has since 2013 received just $98; $2 of each $100 have been withheld and never paid. Continue Reading