Ind. IHCP Hospice Services Provider Reference Module, Section 6, Hospice Quality Reporting Program Rate Reductions

Section 3004 of the Affordable Care Act amended the Social Security Act (the Act) to authorize a Medicare

quality reporting program. This Hospice Quality Reporting Program (HQRP) requires a reduction of

2 percentage points in the market basket utilized by Medicare to set the subsequent fiscal year Medicare

hospice rates. The Act was amended by the Consolidated Appropriations Act of 2021 (CAA) to increase

the HQRP payment reduction from 2 percentage points to 4 percentage points beginning with federal

fiscal year (FFY) 2024. Medicaid agencies may choose to implement the optional Medicaid hospice rate

reduction for lack of quality reporting. The Indiana Family and Social Services Administration (FSSA)

opted not to implement the HQRP payment reduction for years prior to FFY 2024.

Beginning with FFY 2024, the FSSA has opted to implement the 4-percentage point payment reduction

for hospice providers that do not comply with the HQRP requirements. The FSSA will provide the FFS

claim-processing contractor, as well each managed care entity (MCE) that reimburses hospice services,

with a list of providers that have not met the CMS quality data submission requirements, as well as the

reduced reimbursement rates that should be applied for those providers. The provider list and

reimbursement rates will be updated annually.