Home Health & Hospice Week

Don’t risk 100% payment suspension, MACs warn.

Now that the calendar page has turned to 2024, it’s time for hospices to get serious about reporting their caps.

“The Hospice Cap Self-Reporting for the 2023 Cap Year (10/1/2022-9/30/2023) is due no later than 2/29/2024,” emphasizes HHH Medicare Administrative Contractor National Government Services in a Jan. 3 post to its website.

“If the [Self-Determined Hospice Cap] Report is not received by the due date, a past due letter will be sent within seven days and payments will be suspended at 100 percent,” HHH MAC Palmetto GBA warns on its cap webpage.

Tip: “To prepare the cap calculation, hospices should obtain their Provider Statistical and Reimbursement (PS&R) summary and Hospice Cap reports from the CMS website,” HHH MAC CGS instructs on its cap webpage. “CGS does not send copies of PS&R reports since hospices are responsible for obtaining these reports directly from the PS&R System.”

Note that hospices get an extra day this year due to leap year; the cap is usually due Feb. 28. Some years, however, when the due date falls on a weekend, hospices get even more time. That happened in 2020, when the reports were due on Mon. March 2.