Tag: Palmetto

Final Reminder! Hospice Mandatory Reporting Reminder: Deadline for Self-reporting of Aggregate Cap is Feb 28

Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2021 Cap year no later than February 28, 2022. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) in a timely fashion may result in payment suspension. If you have a Cap-related liability, you are required to submit payment at the time…

Update! Home Health Claims Processing Issues

NAHC became aware of home health claims processing problems in the last several weeks, caused by a Centers for Medicare & Medicaid (CMS) Service systems issue and some Medicare Administrative Contractor (MAC)-specific issues. (See January 12, 2022 NAHC Report for more information.) NAHC quickly began addressing these issues when it was brought to our attention.…

Hospice Mandatory Reporting Reminder: Deadline for Self-reporting of Aggregate Cap is Feb 28

Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2021 Cap year no later than February 28, 2022. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) in a timely fashion may result in payment suspension. If you have a Cap-related liability, you are required to submit payment at the time you submit your report.

In order to calculate the Cap, you must be able to access your hospice’s PS&R data, so if you do not have access to CMS’ Identify Management System (formerly EIDM), through which the PS&R data is available) it is advisable that you take action immediately to ensure timely access so that you can meet the reporting deadline.

All three MACs for Home Health and Hospice have online instructions for self-calculation and submission of the Cap report; the information is available at the following locations:

Palmetto GBA

Recent postings to the Palmetto GBA website about the aggregate cap report are  available HERE and HERE.

Palmetto serves Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas.

CGS

Recent CGS online postings about the aggregate cap report are available HERE.

CGS serves Home Health and Hospice providers in Colorado, Delaware, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, South Dakota, Pennsylvania, Utah, Virginia, West Virginia, Wyoming, and the District of Columbia.

NGS

NGS has updated its Hospice Cap self-calculation guidance; it is available online on the NGS website HERE.  The form is available in the NGS FORMS section.

NGS has two Home Health and Hospice Jurisdictions (JK and J6) and serves providers in the following states:  Alaska, American Samoa, Arizona, California, Connecticut, Guam, Hawaii, Idaho, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, Rhode Island, US Virgin Islands, Vermont, Wisconsin, and Washington.

Hospice Mandatory Reporting Reminder: Deadline for Self-reporting of Aggregate Cap is Feb 28

Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2021 Cap year no later than February 28, 2022. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) in a timely fashion may result in payment suspension. If you have a Cap-related liability, you are required to submit payment at the time…

Home Health Claims Processing Issues

NAHC has become aware of some home health claims processing problems last week and this week because of a Centers for Medicare & Medicaid (CMS) systems issue and some Medicare Administrative Contractor (MAC)-specific issues.  NAHC quickly began addressing these issues when it was brought to our attention. The issues are: Notice of Admission (NOA) claims…

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…