Congressional Activity Reflects Strong Interest in Palliative Care

A series of bicameral and bipartisan actions in Congress in recent weeks has signalled strong support for the expansion and strengthening of palliative care in the United States. As the population ages and more people live longer with greater disability and disease, policymakers are increasingly motivated to build out the palliative care infrastructure so that…

CMS Releases Details of Two New Hospice Quality Reporting Measures

Register for the October 19 Hospice Quality Reporting Program Forum (See details below) Hospices have been anxiously awaiting additional information on two new Hospice Quality Reporting Program (HQRP) measures: Hospice Visits in Last Days of Life Hospice Care Index. These are claims-based measures that CMS has indicated will be publicly posted on Care Compare no…

Update to the Amount in Controversy

The Centers for Medicare Services has announced an update to the he annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed…

Data Alert: CMS Releases Vital Post-Acute Care and Hospice Provider Data for 2019

On September 28, 2021, the Centers for Medicare & Medicaid Services (CMS) posted the annual update of the Post-Acute Care and Hospice Provider Public Use File (herein known as “PAC PUF”) with data for 2019.  The PAC PUF now has data available for years 2013-2019. The PAC PUF presents summarized information on services provided to…

FY2022 Hospice Medicare and Medicaid Base Rates at a Glance

Hospice Medicare FY2022 Pricer Now Available Beginning October 1, 2021, hospice base payment rates will increase by two percent, as published in the final FY2022 Hospice Payment Rule. As is customary, the Medicaid program waits until Medicare rates are finalized to issue guidance on the applicable corresponding hospice payment rates. The Medicaid Financial Management Group…

OIG Reports on Home Health Agency Infection Control Audit

An audit of eight home health agencies (HHAs) by the Office of the Inspector General (OIG) found that most had infection control policies and procedures that met the stndards set by the Centers for Medicare & Medicaid Services (CMS) and followed CMS COVID-19 guidance to safeguard Medicare beneficiaries, caregivers, and staff during the coronavirus pandemic, according…

CMS Launches New Tool to Compare Nursing Home Vaccination Rates

Hospice organizations provide a significant level of services to nursing facility patients and have experienced numerous challenges throughout the COVID-19 Public Health Emergency delivering care to nursing home patients. Therefore, NAHC believes hospice providers might be interested in recent action taken by the Centers for Medicare & Medicaid Services (CMS) to provide public access to…

CMS to Proceeed with Targeted Probe and Educate

The Centers for Medicare & Medicaid Services (CMS) has decided to continue to proceed with the Targeted Probe and Educate (TPE) medical review, which they resumed on September 1, 2021. (Please see NAHC Report CMS Resumes Targeted Probe & Educate.) Although, the Medicare Administrative Contractors (MACs) have been conducting limited medical review since August 2020, a…

Help CMS Improve Your Experience with Provider Resources

The Centers for Medicare & Medicaid Services (CMS) is conducting a study to help it improve your provider experience with resources about the Medicare program and correct billing. NAHC urges you to take this brief survey and share your thoughts with CMS. All responses are confidential. The survey should take about 10 minutes to complete…

Process Revisions for Changes of Information for Medicare Certified Providers

The Centers for Medicare & Medicaid Services (CMS) recently released revised instructions (Transmittal 10975/Change Request (CR) 12386) for processing of Medicare-certified provider information,  transitioning certain functions from the  Survey & Operations Group (SOG) Locations (formerly known as Regional Offices) to the Medicare Administrative Contractors (MACs) and the Provider Enrollment & Oversight Group (PEOG), which is part…