Home Health & Hospice Week
Hospice VBID Billing Glitch Harries Providers
Even though the Medicare Advantage Value-Based Insurance Design (VBID) Model’s hospice carve-in is scheduled to sunset at the end of the year, hospice still must deal with billing headaches right now. The problem: When hospice providers send all notices and claims to both the participating MA Organization and their relevant Medicare Administrative Contractor, “some … claims processed by the MACs are not receiving the correct outcome,” HHH MAC Palmetto GBA reports on its website. “Since the April 2024 System Release, more claims are being paid when they should reject for VBID enrollment, Reason code U532A. Some claims have rejected with U523A when they should not have,” the MAC adds. The solution: “If a Medicare VBID claim was processed and paid or rejected incorrectly prior to April 1, 2024, the hospice may attempt an adjustment to receive the proper outcome,” Palmetto suggests. Otherwise, “Palmetto GBA will provide updates as soon as they are available,” the MAC pledges. Tip: “To help hospices determine who is the payer in VBID, CMS has developed the CY 2024 VBID-Hospice Supplement to Technical and Operational Guidance,” Palmetto offers. “See the coverage scenarios on page 3 and Table 1, Payment Coverage Scenarios, on page 6.” The document is at www.cms.gov/files/document/vbid-hospice-technical-guidance-cy2024.pdf.
Home Health & Hospice Week
- Patient-Driven Groupings Model:
Proposed 4% Budget Neutrality Adjustment Continues HHAs’ Death By A Thousand Cuts
CMS calls for an overall 1.7 percent payment reduction in 2025 proposed rule released June [...] - Reimbursement:
Take A Closer Look At Your Proposed Rate Change
Don’t stop at base rate when gauging proposed cut’s effect on your pay. The base [...] - Compliance:
Medicare Wants To Inspect Your Patient Acceptance Policies
New CoP would cost HHAs nearly $3.2 million in first year. Don’t be surprised if [...] - OASIS:
Say ‘Hello’ To 4 New SDOH Items That May Hit OASIS In 2027
Plus: CMS wants to tweak all-payer collection start date and asks for feedback on new [...] - Value-Based Purchasing:
New VBP Measures May Be In The Offing
No immediate program shifts are a relief to HHAs. Unlike last year, Medicare isn’t proposing [...] - Therapy:
Allowing Therapists To Complete Comprehensive Assessments, Even When Nursing Is Ordered, Is Back On The Table
Could this PHE-era ability be restored? A new Request for Information could lead to some [...] - Regulations:
Proposed Reg Tackles Thorny Service Questions, Tweaks PPEO Definition, And More
Tip: Keep an eye on these 5 topics addressed in proposed rule. Don’t miss the [...] - Industry Notes:
OCR Focuses On Olmstead Compliance In Iowa Case
Other states should follow suit, feds suggest. If you had given up hope on the [...] - Industry Notes:
Hospice VBID Billing Glitch Harries Providers
Even though the Medicare Advantage Value-Based Insurance Design (VBID) Model’s hospice carve-in is scheduled to [...] - Industry Notes:
Pennant To Manage Nonprofit Conn. Health System's HHAs & Hospices
A national chain is partnering with a Connecticut health system. The Pennant Group Inc. “has [...]
