Home Health & Hospice Week
Look Over Your Cap Statements Carefully For Sequester Impact
Demand letter doesn’t spell out details.
Another Medicare Administrative Contractor has started sending out hospice cap demands with sequestration funds included.
Background: After much confusion, the Centers for Medicare & Medicaid Services finally indicated that it will include sequester funds in hospices’ per patient caps, even though they never received the sequester payments (see Eli’s HCW, Vol. XIV, No. 24, No. 9). Palmetto GBA began sending out the cap notices with the sequestration amounts included first, and now National Govern-ment Services is issuing them also, notes law firm Sheppard Mullin on its blog.
Warning: “The demand letters themselves do not call out the sequestration adjustment,” Shep-pard Mullin attorneys Brian Daucher and Doug Luther say on the firm’s blog. “To see the increase in revenue, and thus increase in demand, hospices need to review the cap calculation table.”
The calculation table shows the sequestration amount, and then a portion of it credited back. The example CMS gave in announcing the methodology showed a credit back of about 80 percent of sequestration funds, but most hospices’ statements are showing credits from only 15 to 30 percent of sequestration funds, Sheppard Mullin contends.
More information on reading your statement and the firm’s class action lawsuit is online at www.hospicelaw.com.
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