Home Health & Hospice Week

MAC zeroes in on site of service for RHC.

Medical reviewers seem to have plenty of hospice topics to keep them busy at Palmetto GBA.

The HHH Medicare Administrative Con-tractor lists seven hospice topics in its latest Active Medical Review list on its website: Beneficiary Sharing, General Inpatient Care, Routine Home Care, Aggregate Length of Stay, Continuous Home Care, Live Discharge, and Diseases of the Nervous System.

In contrast, Palmetto lists two home health topics: Beneficiary Sharing and Eligibility and Medical Necessity.

Change: Palmetto has “refined the Routine Home Care Targeted Probe and Educate (TPE) edit for hospice,” the MAC says on its website. The MAC “shifted the focus of the editing and claim selection to place of services where the Routine Home Care is being given as defined by OIG reports and internal data analytics,” it says.

Do this: “Providers who had pending ADRs prior to February 13, 2020, should respond with documentation to support the adjudication of the current suspended claims. Providers will be given credit for the reviews prior to the refinement of the edit when Palmetto GBA resumes the claim selection for this TPE action,” the MAC adds.