The aggregate cap is calculated by multiplying the number of Medicaid beneficiaries served by an individual hospice by a “cap amount” — $15,916.98 effective November 1, 1999- October 31, 2000. Hospices with Medicaid expenditures exceeding the cap amount must refund any payments received in excess of the cap. Second, an individual hospice’s aggregate number of inpatient hospice days during a fiscal year may not exceed 20 percent of the total days of care the hospice provides to all Medicaid beneficiaries (State Medicaid Manual, Part 4, section 4306.5). However, states may choose to exclude Medicaid beneficiaries with AIDS when calculating the aggregate limit on an individual hospice’s total inpatient days. The hospice must refund any excess Medicaid reimbursement.
The aggregate cap is calculated by multiplying the number of Medicaid beneficiaries served by an individual hospice by a “cap amount” — $15,916.98 effective November 1, 1999- October 31, 2000. Hospices with Medicaid expenditures exceeding the cap amount must refund any payments received in excess of the cap. Second, an individual hospice’s aggregate number of inpatient hospice days during a fiscal year may not exceed 20 percent of the total days of care the hospice provides to all Medicaid beneficiaries (State Medicaid Manual, Part 4, section 4306.5). However, states may choose to exclude Medicaid beneficiaries with AIDS when calculating the aggregate limit on an individual hospice’s total inpatient days. The hospice must refund any excess Medicaid reimbursement.
https://www.urban.org/sites/default/files/publication/61746/410409-Medicaid-and-End-of-Life-Care.PDF