Home Health & Hospice Week
MCCM Nowhere Near Target Participation Number
The changes the Centers for Medicare & Medicaid Services has made to the hospice concurrent care demonstration project are finally in writing. Reminder: After the Medicare Care Choices Model demo began in 2016, hospices complained that the eligibility criteria made it very difficult to enroll participants. In response, CMS in May 2016 eliminated the requirement for Part D enrollment, and reduced the requirement for two prior inpatient hospital stays to one hospital encounter. When that didn’t seem to go far enough, CMS in January 2017 reduced the requirement for Medicare enrolment prior to model participation from 24 months to 12 months, and scaled down the requirement that within 12 months of model enrollment, the beneficiary must have three office visits with the same physician practice for the eligible diagnosis to three office visits with any physician practice for any condition. CMS announced the most recent changes in the May 3 Open Door Forum for hospice and home care providers (see Eli’s HCW, Vol. XXVI, No. 18). Now they are included in a transmittal and MLN Matters article at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10094.pdf. Underwhelming: In the transmittal, CMS notes that the program’s target for participation is 150,000 beneficiaries. In the May forum, CMS announced that MCCM had enrolled only 834 benes so far. However, the program is expected to pick up speed now that the enrollment criteria have been relaxed, and after 70 more hospices join the program in January 2018. MCCM started with 71 participating hospices in 2016. The demo is scheduled to conclude Dec. 31, 2020. More information about MCCM is at https://innovation.cms.gov/initiatives/Medicare-Care-Choices.
Home Health & Hospice Week
- Therapy:
Follow 8 Documentation Tips To Ward Off Therapy Denials
Denials from Palmetto just keep on coming. One HHH Medicare Administrative Contractor has released results [...] - Medical Review:
Your Therapists Should Know These 11 Items Like The Back Of Their Hands
Is your therapy documentation missing any of these elements? HHH Medicare Administrative Contractor Palmetto GBA [...] - Hospice:
Weigh Carefully Decision To Reprocess Hospice Claims
The fault is CMS’s, but the work is yours. Will the work of correcting claims [...] - Fraud & Abuse:
OIG Hammers Home Health Fraud In Semiannual Report
Report revisits $3.1 million hospice settlement. Home health agencies are front and center when it [...] - Industry Note:
Bill Would Reform, Not Replace, Face-To-Face
HHA record would count, too. If you’re looking for relief from the burdensome face-to-face requirement, [...] - Industry Note:
Prevent 38157 Rejections With Some Education
Stop clogging up the Medicare claims payment system with duplicate RAPs, one HHH Medicare Administrative [...] - Industry Note:
Review Hospice Compare Preview Before It's Too Late
You’ve got until June 30 to review your Hospice Compare preview report and request review [...] - Industry Note:
Medicare Advantage Plans Scrimp On Care, GAO Says
Home care providers have long contended that Medicare Advantage plans aren’t approving enough home care [...] - Industry Note:
MCCM Nowhere Near Target Participation Number
The changes the Centers for Medicare & Medicaid Services has made to the hospice concurrent [...] - Industry Note:
Medicare Shows Its Zeal For Bundling Programs
Home care providers may have heaved a sigh of relief at the three-month delay to [...] - Industry Note:
Prepare Now For Beneficiaries' SSN-Free Medicare Cards
The April 2018 start date for use of Medicare cards with no Social Security Numbers on [...] - Industry Note:
CMS Proposes Extension For HQRP Exception Deadline
The hospice payment proposed rule for 2018 includes new duties and burdens for hospices (see [...]
