Home Health & Hospice Week
Long Stays, GIP Are MAC’s Newest Review Targets
One HHH Medicare Administrative Contractor has finally landed on the hospice medical review topics it wants to pursue, now that review is back in effect. Reminder: In August, the three HHH MACs released their topics as the Centers for Medicare & Medicaid Services announced the resumption of medical review, but CGS didn’t pinpoint hospice targets at that time (see HCW by AAPC, Vol. XXIX, No. 32). Now, CGS has listed two hospice topics for post-payment review, and they are both related to longer-than-average stays. But they also both steer away from claims under COVID-19. No. 1: Length of stay 730+ days (reason code 5M000): “This review selects any hospice claim with a length of stay (LOS) 730+ days excluding diagnosis codes between C00 and D49.9 submitted with dates of service prior to March 1, 2020,” CGS says. No. 2: General Inpatient care ? 7 days (reason code 5M001): “This review selects any hospice claim with revenue code 0656 greater than or equal to 7 days submitted with dates of service prior to March 1, 2020,” CGS explains. CMS has not yet approved any topics for prepayment review. See the list of all CGS home health and hospice medical review topics at www.cgsmedicare.com/hhh/medreview/activitylog.html — current topics are marked “active” in the status column.
Home Health & Hospice Week
- Finance:
It’s Official: New Cost Report Requirements Retroactive To January 2020
Tip: You must separate Medicare, Medicaid, and ‘Other’ data. Here's where managed care falls. If [...] - Provider Relief Fund:
Round 3 Of Provider Relief Funding Offers ‘Add-Ons’ to Previous Recipients
Feds set to release another $20 billion to beleaguered providers. Home health and hospice agencies [...] - COVID-19:
Rapid Response Tests On Their Way To HHAs, Hospices
Beware of overreliance on the tool. The Department of Health and Human Services is following [...] - Reimbursement:
New Rules Smooth Out No-Pay RAP Wrinkles
HHAs should catch a break on RAPs timely filed, then canceled. No home health agency [...] - Industry Notes:
Long Stays, GIP Are MAC’s Newest Review Targets
Hospices’ reprieve didn’t last long. One HHH Medicare Administrative Contractor has finally landed on the [...] - Industry Notes:
Feds Put Extra Funding Into Keeping Beneficiaries At Home
CMS is putting its money where its mouth is when it comes to keeping patients [...] - Industry Notes:
Hospice Carve-In Areas Mapped Out
To find out whether you may get swept into the program testing hospice as a [...] - Industry Notes:
Renewed PHE Means Renewed Regulatory Flexibilities
To no one’s surprise, Health and Human Services Secretary Alex Azar has renewed the public [...] - Industry Notes:
Don't Let Hospice Election Statement, Addendum Haunt You
It’s past Oct. 1, and ghosts and goblins aren’t all that’s scary this month. Your [...] - Industry Notes:
Dump PDGM Behavior Cut, Rep Urges
The home health industry isn’t giving up its fight to make Patient-Driven Groupings Model payment [...] - Industry Notes:
Epic Fraud Takedown Charges More Than 100 Docs, Nurses, Clinicians
If you think enforcement agencies have been taking it easy during the pandemic, think again. [...] - Industry Notes:
CA Last In HH PEPPER Downloads
Are your competitors perusing their PEPPER benchmarking reports to improve and optimize their marketing potential? [...] - Industry Notes:
Whistleblower Sues Over Kickbacks, Ineligible Patients
A Kansas hospice is facing whistleblower charges that it kept ineligible patients on service and [...] - Industry Notes:
Warning: Cyberattacks Skyrocket
You’re not paranoid — your electronic systems are under greater threat than ever before. “The [...]
