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…