New Medicare requirements for hospice certifying physicians will now take effect June 3, 2024, instead of the original May 1 effective date. CMS announced the action in an MLN newsletter on April 25.

The changes for certifying physicians, included in the CMS FY24 Hospice Final Rule, are part of a CMS initiative to strengthen integrity and quality of care amid concerns over hospice fraud and waste.

Overview

In the MLN article, CMS said it would deny hospice claims if certifying physicians aren’t in its  PECOS hospice ordering and referring files by the effective date.

For your agency to receive Medicare reimbursement, two categories of physicians who certify patient eligibility for hospice services must either enroll or opt out of the Medicare program by June 3, 2024.

The new rule applies to the following physicians:

• Hospice medical directors or physicians within an interdisciplinary group who certify patients for hospice care.
• Patient-designated attending physicians (if applicable) who certify patients.

Details

A CMS MLN Educational Tool provides essential information on hospice certifying enrollment for affected physicians and important concepts, including program applicability and details on how to enroll. Click here to access the full article. (See “Certification Requirements.”)

Need additional information? Use the following links to discover more:

• CMS Fact Sheet FY24 Hospice Final Rule
• CMS Hospice Certifying Enrollment Q&A
• CMS Hospice Claims Edits for Certifying Physicians
• MLN Connects 2023-11-16
• CMS Manual Change Request 13342
• CMS FY24 Hospice Final Rule

Please note: The effective date on CMS materials may not yet have been updated.