FY2021 Hospice Medicare and Medicaid Base Rates – At a Glance

Beginning October 1, 2020, hospice base payment rates will increase by 2.4 percent, as published in the final FY2021 Hospice Payment Rule.  As is customary, the Medicaid program waits until Medicare rates are finalized to issue guidance on the applicable corresponding hospice payment rates.  The Medicaid Financial Management Group recently issued a memorandum containing the…

New Dept of Labor Rule Leaves Home Care Unclear on Leave Exemption

On late Friday, the U.S. Department of Labor issued a “Temporary Rule” in response to an August 3, 2020 decision of a federal court in New York that invalidated the department’s earlier rulemaking. While there remains a legal issue as to whether the court’s ruling is limited to New York, DOL chose to issue a…

Medicare Secondary Payer Questions Updated

The Centers for Medicare & Medicaid Services (CMS) released Transmittal 10342/Change Request (CR) 11945, Update to the Model Admission Questions for Providers to Ask Medicare Beneficiaries. This transmittal updates the Medicare Secondary Payer (MSP) manual with model questions providers could ask beneficiaries upon admission. As part of a Medicare provider’s basic commitment, it must agree “to…

NAHC to CMS: Roll Back 2020 Rate Adjustment Based on Faulty Prediction of HHA Behavior

The National Association for Home Care & Hospice (NAHC) urged the Centers for Medicare & Medicaid Services (CMS) to roll back the 2020 rate adjustment CMS instituted based on a prediction of how home health agencies (HHA) would behave that has not materialized. That recommendation, and several more, are part of NAHC’s formal comments to…

NGS Collaborative Medicare Summit goes Virtual, Expands to Include Hospice, Home Health, and Parts A, B Education

Medicare Part A, Part B and Home Health & Hospice providers and vendors from all Jurisdictions are invited to join the National Government Services Collaborative 2020 Virtual Part A/B, Home Health & Hospice Medicare Summit, scheduled for September 22 – 24. Registration is now open for this FREE live educational webinar event that will host 30 subject matter…

HHS Extends Application Deadline for Medicaid Providers, Will Reopen Portal to Certain Medicare Providers

The Department of Health and Human Services (HHS) announced an application deadline extension for the Phase 2 general distribution to Medicaid, Medicaid managed care, Children’s Health Insurance Program (CHIP) and dental providers, as part of an effort to provide financial relief to health care providers affected by the COVID-19 pandemic. HHS also plans to allow…

Oncology Care Evaluation Finds Little Impact of Model on Use/Timing of Hospice Election

Access to Palliative Care and Advance Care Planning Enhanced Since 2016, the Centers for Medicare & Medicaid Services (CMS) has been conducting an alternative payment model based on six-month episodes for cancer care to test whether financial incentives connected to care performance can improve quality and reduce Medicare spending.  The Oncology Care Model (OCM) applies…

OIG: CMS Could Save Money Reviewing Home Health Claims With Visits Slightly Above LUPA

The Centers for Medicare & Medicaid Services (CMS) could have saved $192 million by targeting home health claims for review with visits slightly above the threshold that triggers a higher Medicare payment, according to a new report from the Office of Inspector General (OIG) of the Department of Health & Human Services. Home health agencies…

COVID-19 Accelerated/Advance Payments Reminder — Get Ready for Repayment Withholds on Claims!

Medicare providers who qualified for accelerated and advance payments (AAP) during the COVID-19 Public Health Emergency (PHE) could have payments recouped in the next few weeks.  In the interest of improving cash flow for Medicare providers during the PHE, the Centers for Medicare & Medicaid Services (CMS) issued guidance in late March 2020 allowing providers…

CMS to Extend Medicare Care Choice Model

​The Centers for Medicare & Medicaid Services (CMS) will extend the Medicare Care Choices Model (MCCM) by one calendar year, through December 31, 2021, allowing more Medicare beneficiaries to access supportive care. MCCM tests a new option for Medicare beneficiaries to receive supportive care services from selected hospice providers. It evaluates whether those services can…