CMS Issues Guidance on Determining Hospice Beneficiary Enrollment in MA VBID Hospice Model for CY2022

CMS Orders Systems Changes to Identify Hospice Patients in the Model In calendar year 2022 (CY2022), the Medicare Advantage (MA) Value-based Insurance Model (VBID) Hospice Component demonstration model – under which the hospice benefit is included as part of the MA benefit package — will enter its second year of operation and it is believed he…

Full Common Working File Eligibility Sunset Due by December 2021

Given the historical reliance of hospice providers on the Common Working File (CWF) for eligibility queries, the National Association for Home Care & Hospice (NAHC) has been closely following developments related to the Centers for Medicare & Medicaid Services’ (CMS’) planned phase out of access to the CWF for eligibility queries (see HERE and HERE).…

Attention Billers: Medicare Secondary Payer Problem With HETS

The Centers for Medicare & Medicaid Services (CMS) and the Medicare Administrative Contractors (MACs) are aware of a problem with the HIPAA Eligibility Transaction System (HETS) Medicare Secondary Payer (MSP) data received from the Common Working File (CWF).  The MACs’ eligibility systems/portals that receive MSP data from HETS may be affected by this issue. Due…

Movement to HETS as Sole Source for Eligibility Queries on Horizon

CWF: 3rd and later hospice benefit periods not calculating correctly In recent years, the Centers for Medicare & Medicaid Services (CMS) has taken steps to transition providers away from direct queries to the Common Working File (CWF) and toward the HIPAA Eligibility Transaction System (HETS) as the single source for beneficiary eligibility transactions.  Earlier this…