CMS Proposes to Require a Notice of Admission

The Centers for Medicare & Medicaid Services (CMS) is proposing to eliminate the advance, split percentage payments for all home health agencies (HHAs) in 2021. Therefore, agencies will no longer submit Requests for Anticipated Payment (RAPs) beginning January 1, 2021. The RAP submission opens a home health prospective payment system (HHPPS) episode in the CMS…

Office of Inspector General Adds New Items to Home Health Work Plan

The Office of Inspector General (OIG) work planning  is dynamic and adjustments are made throughout the year to meet priorities and to anticipate and respond to emerging issues. A Work Plan was developed and is available to the public.  It is updated monthly with new issues.  In January 2019, there are two new issues of…

New Edit for Hospice Medicare Claim Processing

The Centers for Medicare & Medicaid Services (CMS) released Change Request (CR) 11049/Transmittal 4187, Ensuring Only the Active Billing Hospice Can Submit a Revocation, which implements a new edit for hospice claims received on or after July 1, 2019.  Currently, the Common Working File (CWF) will allow Notices of Revocation/Termination (NOTR – Type of Bill…

CMS Further Modifies Processes Related to Redesign of Hospice Periods in CWF

Earlier this year the Centers for Medicare & Medicaid Services (CMS) issued a MLN Matters Article (SE 18007 – Recent and Upcoming Improvements in Hospice Billing and Claims Processing) that announced significant changes to the way hospice periods are configured in the Common Working File (CWF).  MLN SE 18007 also announced improvements to the way…