To:       NHPCO Members
From:  NHPCO Health Policy Team
Date:   July 25, 2012

FY2013 Wage Index Notice and Tables

Late Tuesday evening, July 24, CMS posted the FY2013 wage index notice and tables with wage index values for CBSAs and rural areas.

The notice will appear in the Federal Register on Friday, July 27, 2012.  For the first time, the tables are not included in the Federal Register notice, but posted on the CMS Hospice Center under the section entitled “Wage Index.”

Each year NHPCO produces a State By State/County by County Excel Spreadsheet with the rates for each county in the country.  The chart is complete and can be found here.

Summary of Notice:

1. Phase Out of Budget Neutrality Adjustment Factor FY2013 continues the implementation of the Budget Neutrality Adjustment Factor (BNAF), which will continue through FY2016.  The BNAF is a multiplier to the wage index, which is calculated by CMS before the wage index values are published in Table A and Table B.  The net result of the BNAF for FY2013 is a 0.6% reduction in the rates.
2. Reporting All Diagnoses on Claim Form The CMS Wage Index Notice includes a section on reporting all diagnoses related to the terminal illness on the claim form.  NHPCO is continuing to review this section of the Notice for clarity and will have additional dialogue with CMS about their interest in this section.
3. Update on Payment Reform CMS reports that they are moving forward with hospice payment reform with an external contractor and is exploring multiple approaches to hospice payment reform, including case-mix adjustment. Meetings with stakeholders will continue throughout the process.
4. Update on Hospice Quality Reporting Hospices are required to begin collecting data on quality measures in October 2012 and to submit that data in early 2013.  Hospices who do not report quality data by the deadlines in 2013 will have their marketbasket update reduced by 2 percentage points in FY2014.  The proposed hospice quality data reporting requirements for FY2015 and beyond have been published in the Home Health Prospective Payment Rate Update for Calendar Year 2013 proposed rule.  NHPCO is analyzing the proposed rule at this time and will be working on a comment letter to be submitted by the deadline of September 4, 2012.

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