Checking in on CMS and ACP
As of September 2021, the latest policy changes regarding advance care planning and CMS (Centers for Medicare and Medicaid Services) reimbursement involve an increase in reimbursement for advance care planning services provided to Medicare beneficiaries. The aim of these policy changes is to incentivize healthcare providers to engage in advance care planning discussions with their patients and increase access to these important services for Medicare beneficiaries. Additionally, CMS has expanded coverage for hospice care and palliative care services, which are important components of end-of-life care that can help improve the quality of life for patients with serious illnesses. These policy changes demonstrate a growing recognition of the importance of advance care planning in improving patient outcomes and ensuring that patients receive care that aligns with their goals and values.
According to the Office of Inspector General (OIG) estimates that CMS made approximately $42 million in improper Medicare payments for advance care planning (ACP) services between 2020 and 2021. The OIG found that some providers were not properly documenting and billing for ACP services, which led to overpayments by CMS.
These findings suggest that there may be some challenges with the implementation of CMS's reimbursement policies for ACP services, as providers may not be fully aware of the documentation and billing requirements for these services. This highlights the need for ACP technology and ongoing education and training for healthcare providers to ensure that they are aware of the proper procedures for documenting and billing for ACP services.
Despite these challenges, CMS's efforts to increase reimbursement for ACP services and expand coverage for hospice and palliative care services demonstrate a growing recognition of the importance of advance care planning in improving patient outcomes and ensuring that patients receive care that aligns with their goals and values. It is important for CMS to continue monitoring the implementation of these policies and working with providers to ensure that they are able to provide high-quality ACP services to Medicare beneficiaries.