Home Health & Hospice Week

Train your clinicians on what reviewers will be looking for.How do you prove that your patient with Alzheimer's Disease qualifies for the hospice benefit with a six-month prognosis? Look to one MAC's coverage guidelines for clues.Medicare is cracking down on long-stay hospice patients (see related story, p. 47). In the fourth quarter of 2011, one of hospices' top denial reasons was for terminal prognosis, HHH MAC NHIC said in a Hospice POE Advisory Group Meet-ing earlier this year. Slow-declining diagnoses such as Alzheimer's were most common in the denials, NHIC said according to the meeting minutes.Smart hospices will make sure their documentation for such patients meets guidelines for payment. HH&H Medicare Administrative Con-tractor CGS addresses specific documentation requirements for cancer and eight non-cancer diagnoses in its Local Coverage Determination (LCD), "Determining Terminal Status" (L32015).Cover General Requirements FirstBefore getting into disease-specific particulars, clinicians should document some basic elements common to all [...]