Medicare has released its next round of billing changes, and this one won’t be fun. (The last one wasn’t fun either, but that’s beside the point.) You can find the information here. (Click on the zip file to read the .pdf explanation of the proposed changes.) Clearly, there will be more on this as comments are made and the final rule is posted, but here is my quick gut take.
The biggest change in terms of implementation is that we will now be reporting the time of visits in 15 minute increments. For many hospices, this won’t be a big deal at all. As usual, this rule will be much more painful for smaller hospices than large ones. The small hospices across the nation are going to have a hard time meeting both the new Condition’s of Participation and these new billing rules without converting to an electronic documentation system. Figuring out how in the world to do all of this on paper will be very hard and time consuming.
Just to summarize here. In June Medicare published new rules that make it harder/more expensive to stay in compliance, in October they cut our rates, in November they released billing changes that forced small hospices to spend a lot of money converting to electronic charting. Hmmm, any chance we see another round of small community based hospices going out of business and large stock exchange based hospices taking over? Another bad day for the patients and another good day for the corporations.