Home Health & Hospice Week

Industry Notes:

MAC Clarifies What MA Plans Must Cover In Hospice VBID Model

As the Value-Based Insurance Design Model’s hospice carve-in rolls on, hospices are getting more feedback about related procedures.

For example: “Under the Hospice Benefit Component … participating Medicare Advantage Organizations (MAOs) retain responsibility for all Original Medicare services, including hospice care,” HHH Medicare Administrative Contractor Palmetto GBA explains in a new post on its website. “MAOs must pay for non-hospice care provided to a hospice enrollee during a hospice stay, such as the items, drugs, or services that are furnished to treat a condition unrelated to the terminal illness and related conditions,” the MAC says. “And they must cover other non-hospice care (items, drugs, or services) that are furnished after a hospice stay ends (in the event of a live discharge, including non-hospice care provided on the last day of the stay through the end of the calendar month that the hospice stay ends),” Palmetto adds.

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