VBID Hospice Benefit Component Information Now Available

Published 11/19/2020

Beginning on January 1, 2021, CMS is testing the inclusion of the Part A Hospice Benefit within the MA benefits package through the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model. This test allows CMS to assess the impact on care delivery and quality of care, especially for palliative and hospice care, when participating Medicare Advantage (MA) plans are financially responsible for all Parts A and B benefits.

Currently, when an enrollee in an MA plan elects hospice, Fee-for-Service (FFS) Medicare becomes financially responsible for most services, while the MAO retains responsibility for certain services (e.g., supplemental benefits). Under the Hospice Benefit Component of the VBID Model, participating MAOs retain responsibility for all Original Medicare services, including hospice care.

CMS wants to help hospice providers prepare to participate in the upcoming Model. On November 19, 2020, Palmetto GBA mailed a letter and checklist to impacted hospice providers regarding participating plans, billing and claims processing information. We have posted these materials below on our website for your reference.

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