Tag: Medicare Part D

Free Webinar on Forthcoming CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans

The National Association for Home Care & Hospice (NAHC) and other stakeholder groups have been working with the National Council of Prescription Drug Plans (NCPDP) to improve coordination between hospice providers and Part D plans to ensure appropriate coverage for prescription drugs while patients are on hospice service.

A key issue believed to play a significant role in poor coordination is the length of time it takes for information about a patient’s hospice election to filter through the Centers for Medicare & Medicaid Services’ (CMS’) systems to the Part D prescription drug plans.

CMS is now set to launch a pilot study under which hospice EMR vendors, clearinghouses, and Part D plans will test whether hospice election information can be transmitted more timely from hospice EMR vendors/clearinghouses via an intermediary (called the Part D Transaction Facilitator) directly to the patient’s Part D plan.

In an effort to educate hospice providers, Part D plans, hospice EMR vendors/clearinghouses, and other interested parties, NCPDP is hosting a FREE WEBINAR on June 29 to describe the how the pilot will work. The pilot will utilize the Notice of Election (NOE) 837I Transaction Standard to provide information for the Part D Transaction Facilitator, who will create the NCPDP Telecommunication Standard Nx real-time Hospice enrollment transactions for submission to the Medicare Part D plans. The intent of this new process is to allow for timely Hospice election notification to Medicare Part D Plans.

ABOUT THE WEBINAR

Background:  Join this webinar to learn about a pilot initiative to solve for Hospice enrollment notification delays sent to the Medicare Part D plans that may result in inappropriate payments made by the Medicare Part D plans during a Hospice election period

Date/Time:  June 29, 2022, 1 p.m. EASTERN

Learning Objectives: 
After this educational session, attendees will be able to:

  • Understand the journey from delayed information to real-time information.
  • Describe the Hospice Election Status Nx Transactions and all they do.
  • Learn about becoming an NCPDP/CMS Hospice Election Status pilot participant.

Registration:  To register, go to the following link:  NCPDP – Webinars. Scroll down to Upcoming Webinars and click on Hospice Election Status NCPDP/CMS Pilot. Please note that while most NCPDP webinars require payment, this webinar is complimentary.

Free Webinar on Forthcoming CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans

The National Association for Home Care & Hospice (NAHC) and other stakeholder groups have been working with the National Council of Prescription Drug Plans (NCPDP) to improve coordination between hospice providers and Part D plans to ensure appropriate coverage for prescription drugs while patients are on hospice service. A key issue believed to play a…

Free Webinar on Future CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans

The National Association for Home Care & Hospice (NAHC) and other stakeholder groups have been working with the National Council of Prescription Drug Plans (NCPDP) to improve coordination between hospice providers and Part D plans to ensure appropriate coverage for prescription drugs while patients are on hospice service.

A key issue believed to play a significant role in poor coordination is the length of time it takes for information about a patient’s hospice election to filter through the Centers for Medicare & Medicaid Services’ (CMS’) systems to the Part D prescription drug plans.

CMS is now set to launch a pilot study under which hospice EMR vendors, clearinghouses, and Part D plans will test whether hospice election information can be transmitted more timely from hospice EMR vendors/clearinghouses via an intermediary (called the Part D Transaction Facilitator) directly to the patient’s Part D plan.

In an effort to educate hospice providers, Part D plans, hospice EMR vendors/clearinghouses, and other interested parties, NCPDP is hosting a FREE WEBINAR on June 29 to describe the how the pilot will work.   The pilot will utilize the Notice of Election (NOE) 837I Transaction Standard to provide information for the Part D Transaction Facilitator, who will create the NCPDP Telecommunication Standard Nx real-time Hospice enrollment transactions for submission to the Medicare Part D plans. The intent of this new process is to allow for timely Hospice election notification to Medicare Part D Plans.

ABOUT THE WEBINAR

Background:  Join this webinar to learn about a pilot initiative to solve for Hospice enrollment notification delays sent to the Medicare Part D plans that may result in inappropriate payments made by the Medicare Part D plans during a Hospice election period

Date/Time:  June 20, 2022, 1 p.m. EASTERN

Learning Objectives: 
After this educational session, attendees will be able to:

  • Understand the journey from delayed information to real-time information.
  • Describe the Hospice Election Status Nx Transactions and all they do.
  • Learn about becoming an NCPDP/CMS Hospice Election Status pilot participant.

Registration:  To register, go to the following link:  NCPDP – Webinars. Scroll down to Upcoming Webinars and click on Hospice Election Status NCPDP/CMS Pilot. Please note that while most NCPDP webinars require payment, this webinar is complimentary.

Proposed Physician Payment Rule Addresses Attending Physician Services Provided by RHCs, FQHCs

–CMS Proposes Part D EPCS Exceptions that Exclude Hospice Waiver The Centers for Medicare & Medicaid Services (CMS) recently issued its proposed CY2022 physician payment rule  and, as is frequently the case, the rule addresses some issues relevant to hospice care (as well as other matters).  This article will discuss two hospice issues: Proposed implementing…

NAHC Supports Waiver of Electronic Prescribing Requirements for Part D-covered Controlled Substances Prescribed for Hospice Patients

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), enacted in 2018 to help combat the nation’s opioid epidemic, includes a requirement that prescriptions for controlled substances covered under Medicare Part D drug plans be electronically transmitted by a health care practitioner in accordance with an electronic…

CMS Part D and Hospice Election Data Pilot Set to Begin

The Centers for Medicare & Medicaid Services (CMS) is launching a pilot study to test hospice electronic medical records (EMR) vendors and Medicare Part D plans to determine if hospice election information can be transmitted in a more timely fashion from hospice providers through their EMR vendor and an intermediary directly to the patient’s Part D…

OIG Finds Medicare Part D Still Spending Millions for Hospice Drugs

Over recent years the Department of Health & Human Services Office of the Inspector General (OIG) and others have conducted analyses of spending outside of hospice while patients are on service and determined that Medicare may be paying separately for care (including prescription drugs under Part D) that should be the responsibility of the hospice. …

CMS Finalizes Changes to the Appeals Regulations

On May 7, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that that fine-tunes several of the regulations governing the Medicare appeals process. CMS finalized all the provisions in the rule as proposed. Removal of Requirement That Appellants Sign Appeal Requests CMS finalized its proposal to allow appellants in Medicare…

Upcoming Webinar: Hospice Provider and Medicare Part D Walk Through

In recent years the Centers for Medicare & Medicaid Services (CMS) and other policymakers have been closely tracking spending under Medicare Parts A, B and D while a patient is on a hospice election out of concern that these programs may be inappropriately covering items and services connected to the hospice terminal condition and any…

NAHC Asks Congress to Include Auto-Escalation of Part D Appeals in Medicare Legislation

The National Association for Home Care & Hospice (NAHC) has joined a group of like-minded organizations in writing to members of Congress to ask them to to include auto-escalation of Part D appeals to the Independent Review Entity (IRE) in the Medicare extenders legislation. This would align Part D with the Part C appeals process, which…