Home Health & Hospice Week

Hospices should be on the lookout for patients enrolled in the Medicare Advantage Value-Based Insurance Design (VBID) Model’s hospice carve-in as of Jan. 1.

“For CY 2024, 13 participating MA organizations offer 78 plan benefit packages through the Model,” the Centers for Medicare & Medicaid Services notes in its Jan. 4 MLN Connects newsletter. “We sent information and resources to affected hospices in December,” CMS points out.

Important: “You must send all notices and claims to both the participating MAO and your Medicare Administrative Contractor (MAC). The MAO will process payment, and the MAC will process the claims for informational and operational purposes and for CMS to monitor the Model,” CMS instructs on its VBID Hospice webpage at www.cms.gov/priorities/ innovation/innovation-models/vbid/vbid-hospice-benefit-overview.

Also important: “If you choose not to contract, the participating MAO must continue to pay you at least equivalent to Original Medicare rates for Medicare-covered hospice care,” CMS clarifies.

And “the Model does not permit prior authorization requirements around hospice elections or transitions between different levels of hospice care,” CMS maintains.

Plus: It’s not too early to pay attention to a VBID Hospice change for next year, says Theresa Forster with the National Association for Home Care & Hospice. “CMS has removed the word ‘transitional’ from the ‘transitional concurrent care’ component description to convey greater flexibility relative to the length of time a beneficiary may receive these services,” Forster says in the NAHC listserv.