CMS is raising awareness of the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model.
As noted in the MLN Connects for Dec. 23, 2021, when a Medicare Advantage (MA) enrollee elects hospice, Fee-for-Service Medicare becomes responsible for covering and paying for most services, while the MA plan remains responsible for certain services like supplemental benefits.
Under the model, participating MA plans are financially responsible for all Part A and B benefits, including the Medicare hospice benefit and supplemental benefits. For calendar year 2022, 13 participating MA Organizations will offer 115 plan benefit packages as part of the model component.
Hospice providers in affected areas are receiving information and resources on the model, with more education expected from the Medicare Administrative Contractors (MACs). And CMS encourages all other hospice providers to learn more about this model to prepare for future years.
According to a recent transmittal from CMS to MACs, the service areas impacted by the Hospice Benefit Component are in 21 states and one territory: Alabama, California, Colorado, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Virginia, Washington, Wisconsin and Puerto Rico.