CMS Updates Enrollment Decision Appeals Procedure

The Centers for Medicare & Medicaid Services (CMS) updated Chapter 15 – Medicare Enrollment –  of the Medicare Program Integrity Manual via Change Request (CR) 11210/Transmittal 936 Provider Enrollment Appeals Procedure. This CR deals with provider enrollment appeals and  provides instructions to the Medicare Administrative Contractor (MAC) on handling  reconsideration requests and Corrective Action Plans…

Hospices: Deadline for Self-reporting of Aggregate Cap is March 2

Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2019 Cap year by March 2, 2020 (NOTE:  the deadline usually is the last day in February, but because February 29 falls on a weekend, the deadline shifts to the next business day).  If you have a Cap-related liability, you are…

Appeals Demonstration Expanded to Home Health and Hospice

On Jan.1, 2016, the Centers for Medicare & Medicaid Services (CMS) launched the Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration to test whether further engagement between Durable Medical Equipment (DME) suppliers and the DME QIC would improve the understanding of the cause of appeal denials and, over time, result in more proper…

MAC Listening Sessions – Your Opportunity to Provide Feedback

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…

Appeals Demonstration Expanded to Home Health and Hospice

On Jan.1, 2016, the Centers for Medicare & Medicaid Services (CMS) launched the Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration to test whether further engagement between Durable Medical Equipment (DME) suppliers and the DME QIC would improve the understanding of the cause of appeal denials and, over time, result in more proper…

CGS Extends Direct Data Entry Deadline

CGS asked the National Association for Home Care & Hospice to share with our members that they have extended the deadline for direct date entry (DDE) renewal to November 15, 2019 due to the low percentage of providers having completed the process by the original deadline date.  As of today only 63% of CGS Home…

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…

Have You Retrieved Your Hospice PEPPER?

Don’t miss this NAHC webinar on how to understand and use PEPPER. It’s free to members! As previously reported, the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) became available for hospices to download at the beginning of April. The PEPPER is only available via download from the PEPPER Resources portal.  PEPPER is a…

Please take this Quick Medicare Administrative Contractor Satisfaction Survey

The 2019 MAC Satisfaction Indicator (MSI), a survey administered by the Centers for Medicare & Medicaid Services (CMS), is now available. The MSI is designed to measure your satisfaction as a Medicare provider with the performance of your Medicare Administrative Contractor (MAC). This survey should only take 10 minutes of your time and helps the…

Cost Report Submission Reminders & Updates for Home Health and Hospice Providers

The largest proportion of home health and hospice agencies utilize a calendar year fiscal year and are required by Medicare to submit their cost report by May 31. This article provides reminders of various changes that may impact the cost reporting process for these organizations. Electronic Cost Report Submission/CMS Webinar Starting last year, the Centers…