Reporting Requirements for Home Health & Hospice Affected by Hurricane Laura

The Centers for Medicare & Medicaid Services (CMS) is granting exceptions under certain Medicare quality reporting and value-based purchasing programs to home health agencies located in areas affected by Hurricane Laura due to the devastating impact of the storm. The Centers for Medicare & Medicaid Services (CMS) is granting exceptions under certain Medicare quality reporting…

CMS will retire the original Compare Tools on December 1st

CMS will retire the original Compare Tools on December 1st. Use Medicare.gov’s Care Compare to find and compare health care providers. In early September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov, to streamline the eight original health care compare tools. Since then, you’ve had the opportunity to use and familiarize yourself…

Medicare Fee-for-Service Estimated Improper Payments Fall $15B since 2016

The Centers for Medicare & Medicaid Services (CMS) announced today that the Medicare Fee- For-Service (FFS) improper payment rate has continued to decline, the fourth year Medicare FFS improper payment rate has been below 10 percent, the threshold for compliance established in the Payment Integrity Information Act of 2019. The Medicare FFS estimated improper payment…

COVID -19 Therapeutic Receives Emergency Use Authorization

The Centers for Medicare & Medicaid Services announced that starting November 12, 2020, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat coronavirus disease 2019 (COVID-19) with no cost-sharing during the public health emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an emergency use authorization (EUA) from the U.S.…

Third Evaluation of Medicare Care Choices Model Finds High Satisfaction and Savings

Last month the Centers for Medicare & Medicaid Services (CMS) released its third annual report evaluating findings of the Medicare Care Choices Model (MCCM).  Broadly speaking, the evaluation indicates that the model holds great promise – beneficiaries enrolled in the model were 20 percent more likely to enroll in hospice and entered hospice one week…

CMS Releases Updated Manual Guidance for the Hospice Election Statement and Addendum

The Centers for Medicare & Medicaid Services (CMS) updated the Medicare Benefit Policy Manual, Chapter 9 to reflect changes to the hospice election statement and the new election statement addendum.  CMS Transmittal 10437/Change Request (CR) 12015 revises the Manual to include the following:  In the fiscal year (FY) 2020 Hospice final rule (84 FR 38484),…

CMS Toolkit to Accelerate State Efforts to Enhance Home and Community-Based Services

Today, CMS launched a new toolkit designed for state Medicaid agencies to strengthen their infrastructure and develop robust home and community-based services (HCBS) for eligible beneficiaries. This toolkit is the latest in a series of CMS efforts to promote high quality, person-centered HCBS to safely transition older adults and individuals with disabilities back to their…

CMS Updates Home Health Claim Processing Instructions for Unsolicited Responses

The Centers for Medicare & Medicaid Services (CMS) recently updated the claims processing instructions for Medicare Administrative Contractors (MACs), including instructions for processing multiple unsolicited responses on the same home health claim. Prior to the implementation of PDGM (Patient Driven Groupings Model), there was no need for multiple unsolicited responses to be processed during the…

CMS Updates Hospice Claims Processing Instructions

The Centers for Medicare & Medicaid Services (CMS) recently updated the hospice chapter of the Medicare Claims Processing Manual, changing the billing and processing instructions.  Change Request (CR) 12026 clarifies that in order for the Notice of Termination/Revocation (NOTR) to be accepted into the system, an election period must be established. If the notice of…

CMS Open Door Forum Updates Home Health & Hospice

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice and Durable Medical Equipment (DME) Open Door Forum (ODF) on November 4 where CMS reviewed information and resources it has recently released.  A summary is below. HOME HEALTH CMS provided a high level overview of the provisions of the CY2021 Home Health…