Hospice MAC “Operation Collaboration” Summit Sessions Now Available Online

In mid-September, the Home Health and Hospice (HHH) Medicare Administrative Contractors (MACs) – National Government Services (NGS), CGS and Palmetto GBA – hosted the 2021 Virtual HHH MAC Collaborative Summit titled, “Operation Collaboration: We are all in this Together”. The Summit was comprised of joint sessions that occurred on September 15 and 17, and MAC-specific sessions that were held on September 16. The three-day event was a huge success, with more than 6,400 HHH provider attendees from every HHH jurisdiction in every state in the US. NGS is now hosting a virtual encore of the Summit video recordings for providers that were unable to attend.

NGS has posted 11 of the sessions online at the following location: HHH Summit Encore – YouTube.  The NGS webinars include joint sessions held on the first and third day of the Summit, as well as the NGS-specific sessions that were conducted on day two. These webinars will be available for viewing through November 25. Please note – two sessions are unavailable due to technical issues with the recordings.

CGS and Palmetto GBA have separately posted the sessions that they held on September 16; these sessions are available at the following locations:

The CGS sessions are available on CGS’ GoToStage at the following location:  https://www.gotostage.com/channel/j15education. This is also accessible from the Recorded Webinars icon on the Education Webpage. To access the CGS-specific Summit sessions go to Home Health and Hospice and look for the sessions identified as Summit sessions.

Palmetto GBA-specific sessions are available at the following location:  https://portal.on24.com/wcc/eh/581986/category/34041/featured (a search using “summit” will pull up the four Palmetto-specific sessions)

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…

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The Centers for Medicare & Medicaid Services (CMS) has notified providers and suppliers who received COVID-19 Accelerated and Advance Payments (CAAPs) that the Medicare Administrative Contractors (MACs) began recovering those payments as early as March 30, 2021, depending upon the one-year anniversary of when the first payment was received. The CAAP repayment terms provide as…

Hospice Reminder: Deadline for Self-reporting of Aggregate Cap is March 1

Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2020 Cap year no later than March 1, 2021. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) timely may result in payment suspension. (Note: the deadline is usually the last day of February but because February…

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Medical Review Resumes This Month

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CMS Updates Targeted Probe & Educate Information

The Centers for Medicare & Medicaid Services (CMS) published updated targeted probe and educate (TPE) information contained in Chapter 3 of the CMS Program Integrity Manual (Publication 100-08) through Transmittal 10132/Change Request (CR) 11695. The updates incorporate information about TPE practices providers have experienced, but were not clearly outlined in the Manual. This update includes…

Program Integrity Manual Updated for Identity Theft and Hospice Aggregate Cap Liability

The Centers for Medicare & Medicaid Services (CMS) recently released a new transmittal that updates the chapter of the Program Integrity Manual to address coordination between Medicare Administrative Contractors (MAC) and Unified Program Integrity Contractors (UPIC) in situations of hospice aggregate cap liabilities, as well as addressing Medicare liabilities in situations of provider identity theft.…

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The Centers for Medicare & Medicaid Services (CMS) is holding listening sessions to gather feedback and improve experience with the Medicare Fee-For-Service (FFS) program. This is your opportunity to provide feedback on your MAC – Medicare Administrative Contractor. For home health and hospice there are three MACs: Palmetto GBA, CGS, and NGS. Medicare Learning Network…

CMS Provides Direction to MACs on Use of Adjustment Codes

Via Transmittal 4415/Change Request (CR) 11113 – Medicare Administrative Contractor (MAC) Guidance Related to Use of Adjustment Codes on Adjustment Claims – the Centers for Medicare & Medicaid Services (CMS) directs the MACs to refine the claims adjustment reporting process to categorize adjustments by the origin of the adjustment request. The implementation date is January…