What to Do if a Patient’s MBI Number Changes

The Centers for Medicare & Medicaid Services (CMS) sent out a brief update on the new Medicare cards that were shipped out to all beneficiaries from April 2018 to April 2019. Medicare beneficiaries or their authorized representatives can ask to change their Medicare Beneficiary Identifiers (MBIs); for example, if the MBI is compromised. CMS can…

Attention Billers: Medicare Secondary Payer Problem With HETS

The Centers for Medicare & Medicaid Services (CMS) and the Medicare Administrative Contractors (MACs) are aware of a problem with the HIPAA Eligibility Transaction System (HETS) Medicare Secondary Payer (MSP) data received from the Common Working File (CWF).  The MACs’ eligibility systems/portals that receive MSP data from HETS may be affected by this issue. Due…

What the 2020 Medicare Home Health Final Rule Means

The National Association for Home Care & Hospice held a free-to-all webinar on Wednesday, November 5, 2019, to discuss the 2020 Medicare Home Health Final Rule and answer any questions. If you missed the webinar and would like to view the recording, please GO HERE. On October 31, 2019, the Centers for Medicare & Medicaid…

New Bill to Ease Medicare Restrictions on Telehealth Introduced in Congress

New legislation introduced in both the Senate and House of Representatives on Wednesday would make several important changes to the application of telehealth in the Medicare program. The National Association for Home Care and Hospice (NAHC) engaged directly with Congress on the development of this legislation and joined over 120 organizations in endorsing its introduction.…

CMS Pushes Effort to Curb Medicare Fraud

CMS wants stakeholder input on how best to combat waste, fraud, and abuse in Medicare  The Centers for Medicare & Medicaid Services (CMS) is launching a new five-part campaign to deter and punish waste, fraud, and abuse in the Medicare program, CMS Administrator Seema Verma wrote in a blog post earlier this week. “Medicare’s transformation…

CMS Advises on Sharing Medicare Beneficiary Identifier when Referring Patients

The Centers for Medicare & Medicaid Services (CMS) sent out a brief update on the new Medicare cards that were shipped out to all beneficiaries from April 2018 to April 2019. You can find the Medicare Beneficiary Identifier (MBI) on the remittance advice of a prior claim or from your Medicare Administrative Contractor’s portal (get access if…

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…

Improved Hospice Outreach to Minorities Could Save Medicare $270 Million

Medicare spends 20 percent more, on average, on an African-American patient in the last year of his or her life than for white patients, but increased access to hospice services for minorities could save Medicare up to $270 million per year and lead to improved end-of-life care and experiences for elder minorities and their families.…

CMS Issues Rebuttal Process for Deactivations

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 10978, which provides instructions to the contractors and updates the Program Integrity Manual on provider’s/supplier’s right to a rebut a deactivation of their Medicare billing privileges. A provider/supplier whose Medicare billing privileges have been deactivated may file a rebuttal. A rebuttal provides…

NAHC to CMS: Continue to Protect Medicare Beneficiaries from Enrollment Errors

The National Association for Home Care & Hospice (NAHC) has joined with a group of like-minded organizations to ask the Centers for Medicare & Medicaid Services (CMS) to continue to provide time-limited equitable relief opportunity for select individuals currently or previously enrolled in Marketplace plans who delayed Medicare enrollment during their Initial Enrollment Period (IEP).…