In an MLN article this week, CMS clarifies that Medicare patients enrolled in a Medicare Advantage plans that are participating in the Value-Based Insurance Design (VBID) Model’s Hospice Benefit Component cannot be included in a hospice’s aggregate & inpatient caps. Medicare Advantage plan payments for these patients should be excluded when calculating hospice aggregate and inpatient cap payments for January 1, 2021–December 31, 2024, the performance period of the Model component. Not sure if your patients fall into this category? Visit the VBID Model Hospice Benefit Component Billing & Payment webpage and click the link under “Step Three” for a list of plan benefit packages (PBPs) participating in the Hospice Benefit Component of the VBID Model.
