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
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
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:
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Final Hospice Payment Rules and Rates for FY 2015
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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.
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