FY2018 Hospice Final Rule Published

On August 1, 2017, CMS published the FY2018 Hospice Final Rule. In the final rule, Medicare hospice payments, adjusted for inflation and other factors, will increase an estimated 1% or an estimated $180 million in 2018. This is in comparison to the 2017 final rule, which included a 2.1% increase, or $350 million, in payments.
Some other important items to note include:

As expected, […]

Continue Reading

CMS Releases FY2018 Hospice Proposed Rule

Centers for Medicare and Medicaid Services (CMS) recently released the FY2018 Hospice Proposed Rule. The rule proposes that the overall payments for Hospice providers increase by 1% ($180 Million).
Additionally, the Hospice cap amount for the 2018 cap year would be $28,689.04. In addition to the cap and payment updates, the rule solicits comments regarding the source(s) of clinical information for certifying terminal illness and proposes changes to the Hospice Quality Reporting Program, […]

Continue Reading

Determining Medicare Eligibility for Home Health Services

Before providing home health services that will be reimbursed by Medicare, it’s important for agencies to determine Medicare eligibility. Having the tools you need to verify Medicare eligibility and provide quality care allows you to put patients before paperwork.
What Determines Medicare Eligibility?
Medicare eligibility for home health services requires the following criteria to be met:

The patient must be receiving services under a care plan established and reviewed regularly by a doctor. […]

Continue Reading

CMS Releases Notice Regarding Late Hospice NOEs

On December 1, 2016, CMS released a MLN Matters article addressing timely filing of Notice of Election (NOE) for hospice.
Hospices must file an NOE for each patient within five calendar days after the effective date of the election. If an NOE is not submitted and accepted within this time period, Medicare will not cover and pay for hospice care form the effective date of election to the date of filing the accepted NOE. […]

Continue Reading

Free Webinar: Home Health Regulatory Update

CMS recently released the final rule for the Home Health Prospective Payment System (HH PPS) for CY2017. What is on the regulatory horizon and how will it affect you? Please join HEALTHCAREfirst for a discussion of the regulatory changes for 2017, including the final rule. Topics include:

Rates/Payment changes
Recalibration of case mix
Outlier payment changes
Quality updates
Home Health Value-Based Purchasing
Pre-Claim Review
Automated denials of claims with no OASIS
Important home health regulatory reminders

The 60-minute webinar will be held on Thursday, […]

Continue Reading

2017 Home Health Final Rule Published

CMS released the CY2017 Home Health Final Rule on October 31, 2016. The payment rate portion of the rule is consistent with the proposed rule, with only minor modifications, resulting in a slight rate reduction from 2016 rates.
Some important items to note include:
Outlier Calculations
HHAs who have a high volume of outlier visits may see a decrease in their payment amount due to the methodology change for calculation of outlier payments. […]

Continue Reading

NAHC to File Pre-Claim Review Lawsuit Against CMS

Update: On March 31, 2017, CMS announced that as of April 1, 2017, the Pre-Claim Review demonstration will be suspended for at least 30 days in Illinois. The demonstration will not expand to Florida on April 1, 2017.  CMS will notify providers at least 30 days in advance via an update to their website of further developments related to the demonstration.  […]

Continue Reading

Pre-Claim Review Demonstration Update

Update: On March 31, 2017, CMS announced that as of April 1, 2017, the Pre-Claim Review demonstration will be suspended for at least 30 days in Illinois. The demonstration will not expand to Florida on April 1, 2017. CMS will notify providers at least 30 days in advance via an update to their website of further developments related to the demonstration. […]

Continue Reading

CMS Announces New Pre Claim Model for Home Health Agencies

Three-Year Model to Affect Five States
CMS announced Wednesday they are implementing a three year Pre-Claim model for Home Health. The model had started out as a pre-authorization and morphed into the pre-claim review. Many in the industry had hoped recent collaboration from industry groups, leaders, and members of congress would be enough to convince CMS against moving forward. […]

Continue Reading