Take Action! Urge Congressional Delay of MA-Hospice Carve-in Demonstration

GO HERE to defend hospice right now! Easy and takes only seconds! Join NAHC’s Summer 2020 Backyard Advocacy campaign! In recent months a growing chorus of hospice organizations, Medicare Advantage (MA) stakeholders, and members of Congress have urged the Centers for Medicare & Medicaid Services’ (CMS) to delay the January 2021 launch of a planned…

CMS Issues Billing Guidance Related to Planned Test of Hospice-MA Carve-In

—Despite MA Coverage under Demonstration, Hospices Will Continue to Submit Claims to MACs As announced first in January 2019, starting in calendar year (CY) 2021 (and through CY2024) the Centers for Medicare & Medicaid Services (CMS) will begin a demonstration program under the Value-Based Insurance Design (VBID) model to test coverage of hospice care as…

Final MA Rule Provides Insight into Special Election Periods for Hospice Beneficiaries

The Centers for Medicare & Medicaid Services (CMS) has released the Medicare Program: Contract Year 2021 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program, with important information about the special election period for hospice beneficiaries. In recent years policymakers have given increased attention to current…

CMS Issues Part One of MA Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule: Contract Year 2021 Policy and Technical Changes to the Medicare Program, Medicare Prescription Benefit Program, and Medicare Cost Plan Program. In response to the COVID-19 pandemic and to give the MA plans adequate time to implement the changes, CMS is issuing the…

CMS Announces Hospice MA-VBID Model Webinar Series

In January 2019, the Centers for Medicare & Medicaid Services (CMS) announced plans to test inclusion of the Medicare hospice benefit under the Medicare Advantage (MA) benefit package through its ongoing Value-Based Insurance Design (VBID) MA demonstration program.  Additional details around the model were released in late December as part of CMS’ Request for Applications…

CMS Outlines Planned Payment for Hospice Medicare Advantage Coverage under VBID Test

In CY2021 the Centers for Medicare & Medicaid Services (CMS) plans to test coverage of hospice as part of the Medicare Advantage (MA) benefit package through its ongoing Value-Based Insurance Design (VBID) model. (See this NAHC Report article for more information.)  A December 2019 Request for Applications (RFA) outlining of the model, participating plans must…

CMS Issues Proposals for Medicare Advantage Plans

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule titled: Medicare and Medicaid Programs; Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly. Also released, is Part…

CMS Releases Long-awaited Details on MA/Hospice Carve-in

Demonstration Planned for CY2021 Late December 19, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Applications (RFA) for the Value-Based Insurance Design (VBID) Model Incorporation of the Medicare Hospice Benefit into Medicare Advantage (MA), through which it is seeking participation by MA plans.  Eligible MA plans in all states and…

Annual Update to Threshold Amounts for Medicare Appeals

The annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process has been updated. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2020. The calendar…

Executive Order Provides Limited Detail but Presages Policies to Advance Medicare Advantage, Other Changes

On October 3, President Donald Trump signed an Executive Order (EO) on “Protecting and Improving Medicare for Our Nation’s Seniors” expressing disapproval of efforts by some in Congress to encourage “Medicare for All” policies and, instead, to promote health initiatives endorsed by the Administration.  While the EO does not, of itself, directly change any existing…