CMS Implements Late Filing Penalty for Notice of Elections of Hospice Benefits

On August 22, 2014 CMS published Transmittal 3032 Change Request 8877 effective October 1, 2014.  This change request impacts certain primary diagnoses and reporting filing hospice Notice of Elections (NOE) and Notice of Termination / Revocation (NOTR).  This email blast will cover NOE filing and penalties related to late filing of NOE along with filing of NOTR. Effective October 1st the NOE and NOTR must be filed within 5 days.  If the NOE is not filed within 5 days Medicare will not start coverage until the date the NOE is filed and accepted.  For example if a patient is admitted to a hospice on October 1st and the NOE is filed and accepted on October 10th, Medicare coverage for that patient will not begin until October 10th.  This would mean if the hospice routine home care rate is $150 per day, they would lose 9 days times $150 or $1,350.  They currently is no penalty for late filing of NOTR, but that may change in the future.  CMS has listed four circumstances that may qualify the hospice for an exception the consequences of filing the NOE late.   These include fires, floods, earthquakes and other items.  You can find a complete list in Transmittal 3032 Change Request 8877.   Link to Transmittal Change Request 8877 We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

CMS Eliminate Some Hospice Primary Diagnoses

On August 22, 2014 CMS published Transmittal 3032 Change Request 8877 effective October 1, 2014.  This change request impacts certain primary diagnoses and reporting filing hospice notice of elections.  This email blast will cover the hospice primary diagnosis codes.  Adult Failure to Thrive and Debility will no longer be accepted as primary hospice diagnosis codes. CMS has also listed 35 codes that will no longer be accepted as primary diagnosis.  Any claims issued with these codes received after September 30, 2014 will be returned to the hospices to recode the primary diagnosis.     Link to Transmittal Change Request 8877 We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

CMS Publishes 2015 Final Hospice Rules & Payment Rates in Federal Register

The Final 2015 Hospice Rules and Payment Rates have been published in the Federal Register today.  We have reported previous Email Blast the changes in the Final Hospice Rules and Rates for 2015 along with a temporary link.    Link to the Final Hospice Rules and Rates for 2015 in the Federal Register We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

CMS Issues Three More Change Request for Home Health Agencies

CMS published Transmittal 3005 Change Request 8699 on August 1, 2014 concerning preventing duplicate payments when overlapping Inpatient and Home Health Claims are received out of sequence. This Change Request effective January 1, 2015improves safeguards to prevent payment of home health services when a beneficiary is an inpatient of a hospital or skilled nursing facility. CMS published Transmittal 3010 Change Request 8710 on August 1, 2014 concerning preventing payment on Request for Anticipated Payments (RAPs) when home health beneficiaries are enrolled in Medicare Advantage (MA) Plans.  This Change Request effective January 1, 2015 will modify Original Medicare systems to ensure RAPs are not paid when the final claim for a home health episode will not be payable due to the patient being enrolled in Medicare Advantage Plan. CMS published Transmittal 1405 Change Request 8813 on August 1, 2014 concerning diagnosis reporting on home health claims.  This Change Request effective January 1, 2015instruction adds editing for principal diagnoses that are not appropriate for reporting on the home health claim.   Transmittal 3005 Change Request 8699 Link Transmittal 3010 Change Request 8710 Link Transmittal 1405 Change Request 8813 Link We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

Homebound Clarification Takes Effect September 2, 2014

CMS published Transmittal 192 on August 1, 2014 concerning clarifying the definition of confined to the home as part of homebound status.  The instruction clarifies the definition of the patient as being "confined to the home" to more accurately reflect the definition in Section 1835(a) of the Social Security Act.  It has removed vague terms such as "generally speaking" to ensure clear and specific requirements. Home health agencies should be aware that MACs, RACs, ZPICs, and CERTs will be focusing on home bound status.  This should be the number one documentation issue for all home health agencies.  You should document the home bound status on admission and on every skilled care note.  Remember you can only rely on what is documented to defend your home bound status. We encourage all home health agencies to carefully review the Transmittal 192 and educate their all of their clinical staff to ensure compliance.  Remember the change effective date takes place on September 2, 2014.   Transmittal 192 Change Request 8818 can be downloaded using this link We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561 and asking to speak with Margaret. Registration Form

CMS Eliminated Prior Authorization Edits on all but 4 Categories Hospice Drugs

Due to an uproar from hospice beneficiaries, hospice providers, Part D sponsors, pharmacy benefit managers and concerned hospice advocates, CMS has issued a Program Memorandum to limit Prior Authorization (PA) on all but four categories of drugs for beneficiaries who have elected the hospice benefit.  They have encouraged Part D plan sponsors to place beneficiary-level (PA) on the following drug categories: Analgesics, antinauseants (antiemetics), laxatives, and antianxiety drugs (anxiolytics).  CMS expects Part D sponsors to identify the national drug codes for drugs included within the four categorizes above by utilizing standard industry classifications that are available through drug listing services.  Part D sponsors are not expected to place hospice PA requirements on other categories of drugs or take special measures beyond their normal compliance and utilization review activities to retrospectively review paid claims for purposes of determining whether drugs in the other categories were unrelated to the hospice beneficiary's terminal illness and related conditions or payment recovery.  CMS continues to expect that Medicare hospice providers will continue to provide all of the medications that are reasonable and necessary for the palliation and management of a beneficiary's terminal illness and related conditions  Link to the July 18, 2014 Program Memorandum CMS has a special form "Hospice Information for Medicare Part D" that may be used to provide necessary information generally requested by Medicare Part D Sponsors. Link to Hospice  Information For Medicare Part D Form We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

Update from Final Hospice Payment Rules & Rates for FY 2015

In the proposed rules CMS required hospices to submit the patient Notice of Election (NOE) of hospice benefits within three days or face penalties.  This has been changed to five days, but it means if a hospice does not submit the (NOE) within five days they will be penalized.  A good example if a patient elects hospice benefits and is admitted to the hospice on November 1, 2014 and the hospice files the (NOE) on November 8, 2014, Medicare will only pay for hospice services starting on November 8th.  Any services provided by the hospice between November 1st and November 7th will be non-covered and those days cannot be billed to Medicare.  This is a big change that would cause the average hospice to lose $1,115.38 in Medicare reimbursement for the above patient.   This is just one of the many changes in the Final Hospice Payment Rules and Rates for FY 2015.  Temporary Link to the Hospice Final Rule The above link will change when it is published in the Federal Register.  We will provide an email update with the final link when it is published in the Federal Register. We will also be holding a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  on Wednesday August 27, 2014  from 3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT). For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

Final Medicare Hospice Payment Rates FY 2015

Final Medicare Hospice Payment Rates FY 2015

CMS has issued the final Hospice Payment Rates for 2015.  The chart below shows the Final FY 2014 rates compared to the Final FY 2015 rates.

Code   Description                                         FY 2014 Rate               FY 2015 Rate

651      Routine Home Care                            $156.05                       $159.34

652      Continuous Home Care

            24 Hours of Care                                 $910.76                       $929.91

            Per Hour                                              $37.95                         $38.75

655      Inpatient Respite Care                        $161.42                       $164.81

656      General Inpatient Care                       $694.19                       $708.77

Remember the above rates are national rates and they must be adjust by the wage index to obtain the rate for a particular area of the country.

Temporary Link to Final Rule: http://ofr.gov/OFRUpload/OFRData/2014-18506_PI.pdf

The above link will change when it is published in the Federal Register.  We will provide an email update with the final link when it is published in the Federal Register.

We will also be holding a webinar titled "Final Hospice Payment Rules and Rates for FY 2015" on Wednesday August 27, 2014 from3:00 pm to 4:00 pm Eastern Daylight Savings Time (EDT).  For more information please see below:

Final Hospice Payment Rules and Rates for FY 2015  We have a Special Live and On Demand Webinar onWednesday August 27, 2014 from  3:00 - 4:00 PM EDT 2:00 - 3:00 PM CDT 1:00 - 2:00 PM MDT  12:00 - 1:00 PM PDT & MST 11: AM - 12:00 PM AKST 9:00 - 10:00 AM HAST This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form