CMS Resumes Targeted Probe & Educate

NAHC urges CMS to suspend TPE until the public health emergency ends The Centers for Medicare & Medicaid Services (CMS) indicated in an August 2021 MLNConnects newsletter that it will resume the targeted probe and educate (TPE) program that was suspended in March 2020 (as were most medical reviews) due to the COVID-19 public health…

CMS Extends Medical Review Dates

The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare Administrative Contractors (MACs) may now begin conducting post-payment medical review for later dates of services. On March 30, 2020 the Centers for Medicare & Medicaid Services (CMS) suspended most Medicare Fee-For-Service (FFS) medical review because of the COVID-19 pandemic.  On August 17, 2020…

Hospices: Deadline for Self-reporting of Aggregate Cap is March 2

Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2019 Cap year by March 2, 2020 (NOTE:  the deadline usually is the last day in February, but because February 29 falls on a weekend, the deadline shifts to the next business day).  If you have a Cap-related liability, you are…

Appeals Demonstration Expanded to Home Health and Hospice

On Jan.1, 2016, the Centers for Medicare & Medicaid Services (CMS) launched the Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration to test whether further engagement between Durable Medical Equipment (DME) suppliers and the DME QIC would improve the understanding of the cause of appeal denials and, over time, result in more proper…

Appeals Demonstration Expanded to Home Health and Hospice

On Jan.1, 2016, the Centers for Medicare & Medicaid Services (CMS) launched the Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration to test whether further engagement between Durable Medical Equipment (DME) suppliers and the DME QIC would improve the understanding of the cause of appeal denials and, over time, result in more proper…

CGS Extends Direct Data Entry Deadline

CGS asked the National Association for Home Care & Hospice to share with our members that they have extended the deadline for direct date entry (DDE) renewal to November 15, 2019 due to the low percentage of providers having completed the process by the original deadline date.  As of today only 63% of CGS Home…

Cost Report Submission Reminders & Updates for Home Health and Hospice Providers

The largest proportion of home health and hospice agencies utilize a calendar year fiscal year and are required by Medicare to submit their cost report by May 31. This article provides reminders of various changes that may impact the cost reporting process for these organizations. Electronic Cost Report Submission/CMS Webinar Starting last year, the Centers…

Hospices: Is Your Cap Report Good to Go?

As referenced previously, Medicare-participating hospice programs have until Thursday, February 28, 2019, to calculate and transmit their 2018 Aggregate Cap report to their Medicare Administrative Contractor (MAC), along with any Cap liability (if one exists).  If the MAC does not receive the hospice’s completed report by the due date of February 28, 2019, the MAC…

Hospices Have Limited Time to Submit Aggregate Cap Report

The hospice self-determined aggregate cap reports and any overpayments are due February 28, 2019.  Hospices have been completing their own cap reports and submitting them to their Medicare Administrative Contractor (MAC) since the 2014 cap year. If the MAC does not receive the hospice’s completed report by the due date of February 28, 2019, the…

CMS Proposes to Begin RCD on December 10, 2018

The Centers for Medicare & Medicaid Services has issued a second Paperwork Reduction Act (PRA) notice for public comment for the Home Health Pre-Claim Review Demonstration (A.K.A. Review Choice Demonstration). This notice is for a 30-day public comment period CMS proposes to initially implement the demonstration in Illinois, Ohio, North Carolina, Florida, and Texas with…