Home Health & Hospice Week

Industry Note:

SMRC Launches New Review On GIP In SNFs, ALF Services

Hospices are set to undergo even more scrutiny of GIP claims, thanks to a newly announced medical review project for Medicare’s Supplemental Medical Review Contractor Noridian Healthcare Solutions. But the project has another focus as well — care provided in facility settings.

Background: Back in February, Noridian announced a project targeting hospice General Inpatient claims from 2017 (see Eli’s HCW, Vol. XXVIII, No. 9).

Now Noridian has posted another project, called “Hospice Portfolios” that will target “claims for general inpatient hospice billed on dates of service from January 1, 2018, through December 31, 2018,” according to the SMRC’s website. This time, reviewers will focus on GIP provided in Skilled Nursing Facilities (phase one), then other hospice services provided in Assisted Living Facilities (phase two), Noridian says at www.noridiansmrc.com/current-projects/01-013.

More ahead: Don’t be surprised if Noridian announces more hospice projects down the line, says the National Association for Home Care & Hospice. Plus, “the SMRC can begin work on a project without it being posted, and we have heard from providers that Noridian has been doing this for this most current project and may be doing it for other un-posted projects,” NAHC’s Theresa Forster says in a message to members.

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