Home Health & Hospice Week

If you don’t submit your self-determined hospice cap report to CGS by the Feb. 28 deadline, the Medicare Administrative Contractor will start withholding your reimbursement March 7, the MAC warns in a message to providers.

And it may not be easy to get back off that withhold right away. “CGS processes SD Cap submissions on a First In First Out basis,” the MAC says. “If your agency is put on withhold, [the] possibility exists you could stay on withhold for several days after we receive your submission, depending on [the] number in front of you to be reviewed.”

“Suspension of Medicare payments” resulting from failing to report your cap “can have a serious impact on cash flow,” warns Sandy McCleve with Advantage Healthcare Consulting Cost Report & Reimbursement in Utah.

Don’t forget: Any overpayments “must be remitted back to the MAC upon filing,” McCleve reminds providers. But you can apply for an extended repayment schedule (ERS).

That’s why “we recommend securing the PS&R data at the earliest available date to minimize any current liability that may exist,” says consulting firm The Health Group in Morgantown, West Virginia, in its electronic newsletter. “If your hospice has a cap liability, you have until February 28, 2019 to submit the cap Report and the ERS Request even if you secured the PS&R data on January 4, 2019,” it says.

There’s another good reason to download your data ASAP too, McCleve points out: “Assess your agency’s situation now, so there are no surprises when you go to file,” he advises. “You will then have adequate time to gather all the necessary information together to apply for and file an ERS.”

More cap report submission information and advice from Advantage is at https://advantagehcconsulting.com/blog/2019/01/09/hospice-capreporting-are-you-prepared-to-file-2.