CMS Directs MAC Outreach to Hospices in MA VBID Demonstration Model Areas

Beginning on January 1, 2021, through the VBID Model, participating Medicare Advantage Organizations (MAOs) can voluntarily participate in the Hospice Benefit Component of the Model, according to a November 13 transmittal (10458/CR 12045) from the Centers for Medicare & Medicaid Services (CMS).  During CY2021, nine plans will test coverage of Hospice as part of their…

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…

Movement to HETS as Sole Source for Eligibility Queries on Horizon

CWF: 3rd and later hospice benefit periods not calculating correctly In recent years, the Centers for Medicare & Medicaid Services (CMS) has taken steps to transition providers away from direct queries to the Common Working File (CWF) and toward the HIPAA Eligibility Transaction System (HETS) as the single source for beneficiary eligibility transactions.  Earlier this…

Review Choice Demonstration to Begin in Ohio on September 30, 2019

The Centers for Medicare & Medicaid (CMS) announced today that the next state to participate in the Review Choice Demonstration (RCD) is Ohio and it will begin on September 30, 2019. In the same announcement, CMS also stated it anticipates 60-90 days between beginning the demonstration in the remaining states of Texas, North Carolina and…

CMS Announces Start Date for Review Choice Demonstration

The Centers for Medicare & Medicaid Services (CMS) posted long-awaited information this morning about the next steps for its Review Choice Demonstration, which will begin in Illinois on June 1, 2019. As reported previously in NAHC Report, CMS announced its plans to modify the Pre-Claim Review Demonstration, now called Review Choice Demonstration, on May 30.…