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MedicaidReimbursementMedium impact

Nursing Facility Rate Changes Affecting Hospice Patient Room and Board Payment

Illinois Medicaid - HFS·IL · Palliative Care·Provider Notice
Effective date
Jul 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Nursing facility rate changes effective July 1, 2020 will impact hospice room and board payments. Managed Care plans are paying at new rates, but fee-for-service claims continue at old rates until CMS approval. Hospices must void and rebill fee-for-service claims if necessary.

Action Required

Action needed
Immediately: Hospice billing teams must monitor fee-for-service claims for room and board charges paid at old nursing facility rates (pre-July 1, 2020 rates). Void and rebill these claims once CMS approves new rates for fee-for-service reimbursement. Contact hospice billing consultant at 877-782-5565 for questions. Note: No automatic adjustments will be made by the Department.