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Hospice Insider - 2014; Volume 7, Number 12
Compliance:
OIG Targets Hospice In 2015 Work Plan
GIP, ALF relationships top hospice hit list. Watch for two OIG reports on HHAs to come...
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Business:
Hospices Open, Expand Facilities Across The Nation
Nursing homes, hospitals make willing partners to hospice facility growth. As regulati...
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Referrals:
Alert Your SNF Partners To Hospice Changes In RAI Manual
Note these key revisions in Chapter 2. The Centers for Medicare & Medicaid Service...
Read more
Studies & Surveys:
Focus On These Cancer Patients To Facilitate Hospice Access
New study points the way to underserved populations. If you don’t see a lot of h...
Read more
Quality:
Newspaper Offers Up 'Hospice Compare' Substitute
Washington Post continues its scrutiny of the industry. You’d better make sure y...
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HIPAA:
New HIPAA Audits Could Cost You
Get ready for a second round of OCR audits. Now that the Phase 1 audits have finished,...
Read more
Lawsuits:
Whistleblower In San Diego Hospice Case May Net Seven Figures
Employees receive settlement from Labor Act also. A whistleblower who filed suit...
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Hospice News:
Terminal Diagnosis Figures In OIG Claims Determinations
Hospice sees 7 percent of claims kicked out by federal watchdog agency. Hospices hopin...
Read more
Hospice News:
Follow Up On HQRP Reconsideration Requests
If you submitted a request for reconsideration on your Hospice Quality Reporting Pr...
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Hospice News:
Find Out How To Use Your PEPPER Correctly
You now can receive new PEPPER training at your convenience. Hospice PEPPER contrac...
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Hospice News:
MAC Updates Hospice Payment Rate Calculator
Want a quick way to check your hospice payment rate now that rates have changed? HH...
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Hospice News:
Choose Your CAHPS Vendors From Final List
If you’ve put off choosing a hospice CAHPS vendor because CMS’s vendor list ...
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Hospice News:
Hospice Doc Pleads Guilty
A newspaper exposé about a long-stay hospice patient getting hooked on narcotics ...
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Reader Question:
When Should You Use Q5003 Versus Q5004 For Hospice?
You may have to tweak your information-gathering for nursing home residents. Question:...
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Hospice Insider - 2014; Volume 7, Number 11
Reimbursement:
New Short Cap Repayment Timeline Will Prove Burdensome
CMS implements new aggregate cap procedures but leaves inpatient cap as-is. If you fai...
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Know Your Facts:
Feds Used These Stats To Decide On Your Cap Requirements
More than one in 10 hospices exceeds its per patient cap. Wondering why the Centers fo...
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Finance:
Hospices Must Adjust To New Hospice Cost Report, Unless They Fall Into This Category
Potential cost report problem cleared up by CMS clarification. Hospices need to be get...
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Quality:
Get A Jump On Your CAHPS Contracting
The CAHPS dry-run period is looming large. There’s no time to waste when it come...
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Regulations:
The Heat Is Off Hospice Bundling -- For The Moment
CMS holds off on ‘terminal illness’ and ‘related condition’ defi...
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Eligibility:
Clinical Documentation Must Back Up Doc's Eligibility Determination, CMS Stresses
Will your claims withstand eligibility review? The feds appear to be laying the ground...
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Regulations:
Hospices Protest Additional Burden Under New Attending Physician Requirements
CMS tries to head off coerced changes to patients’ physicians. New procedures fo...
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Survey & Certification:
Hospice Survey Frequency Upped To Every 3 Years
IMPACT law also targets hospices with long-stay patients for scrutiny. After a series ...
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HIS:
Get These Answers To Your HIS Questions
CMS explains HIS rules for transfers, submission problems. Transfer patients get a dou...
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Industry Notes:
MAC: New NOE Deadline Applied To Oct.1 Admissions
Consult Q&As for more CR 8877 clarifications. Don’t sweat it if you didn&rsq...
Read more
Hospice Insider - 2014; Volume 7, Number 10
Compliance:
Be Ready For 5-Day NOE Deadline That Hits Oct. 1
Notices of Termination/Revocation also subject to the new time limit. Hospices will ha...
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Regulations:
CMS Grants Exceptions To NOE Filing Deadline
Hint: An IT meltdown will not qualify you for a filing deadline exception. CMS got an ...
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Reimbursement:
Medicare Bumps Up Hospice Rates By 1.4% In October
Sequestration reductions likely to continue to harm hospices’ bottom lines. Hosp...
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Diagnosis Coding:
Nix These 40 Diagnosis Codes For Hospice Claims
Debility, Adult Failure To Thrive, Dementia codes and more will get your claim kicked ba...
Read more
Billing:
Don't Let NOE Billing Mistakes Result In Returned Claims
Use this modifier to indicate your request for an NOE deadline exception. At CMS&rsquo...
Read more
Documentation:
Add These Attending Physician Changes To Your Hospice Duties
Tip: Make sure your election form includes language indicating patient choice. If you ...
Read more
Compliance:
Include This Physician Info On Your Own Attending Change Form
Make sure your patients’ election statements comply with new rules Oct. 1. You h...
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Hospice Notes:
Feds Intervene In Two Whistleblower Lawsuits Against Hospice Chain
Marketing practices land hospice in the hot seat. Alleged high pressure on employees t...
Read more
Hospice Insider - 2014; Volume 7, Number 9
Prior Authorization:
CMS Pares Back Prior Authorization To Just 4 Types Of Drugs
Prior authorization is still in effect for analgesics, antinauseants, laxatives, and ant...
Read more
Coverage:
Use One Simple Word To Categorize PA Drugs As Unrelated
Warning: But your clinical documentation had better tell the whole story. You may be c...
Read more
Reimbursement:
Follow 6 PA Steps To Head Off Medication-Related Headaches
Tip: Get to know the new standardized prior authorization form. Hospices struggling wi...
Read more
Billing:
2 MACs Fix Infusion Pump-Related Claims Glitch With Override
Warning: Don’t forget to resubmit affected claims for your rightful reimbursement....
Read more
Quality Improvement:
QIO Restructure Leads To Separation Of Review, Quality Improvement Duties
Only 2 QIOs will perform medical review. Heads up: You may have a new Quality Improvem...
Read more
Hospice News:
Choose Your CAHPS Vendor This Fall
The CAHPS dry run is coming up fast. The hospice Consumer Assessment of Healthcare Pro...
Read more
Hospice News:
Excluded Employee Costs Hospice Six Figures
Are you running periodic checks of your employees against the OIG’s excluded list?...
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Hospice News:
Get HIS Info From New Fact Sheets, Q&As;
Medicare is offering you a helping hand with the Hospice Item Set. The Centers for Medic...
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Hospice News:
MAC Offers Advice On Hospice POC Denials
If you’re receiving claims denials related to the hospice plan of care, you’...
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Hospice News:
RAC Review Of Hospice Coverage Underway
One of the Recovery Audit Contractors has had a hospice issue approved for months, but t...
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Hospice News:
RN Workforce Larger Than Experts Predicted
If your nurse hiring isn’t as squeezed as you expected lately, it may be because R...
Read more
Hospice Insider - 2014; Volume 7, Number 8
Hospice Item Set:
Watch Out For Noncompliance With HIS Completion Date
Ready or not, the Hospice Item Set requirement is upon you. Whether you worked diligen...
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Quality:
HIS Data You're Now Collecting Will Result In These 7 Quality Measures
Plus: Get to know the HIS tool sections that will generate the quality standards. It...
Read more
Data Collection:
Use 10 Tips To Master HIS Collection Requirements
Tracking deadlines is essential to compliance. Your future reimbursement is on the lin...
Read more
Resources:
Improve Your HIS Data Collection And Submission With These Educational Resources
Have you checked out all of CMS’s instructions on filling out the Hospice Item Set...
Read more
Regulations:
Medicare Explores Provision Of Hospice, Curative Care Concurrently
Proposed NOE deadline, CAHPS requirements also raised in Open Door Forum. The answer t...
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Hospice News:
Observe 5-Day Respite Day Limit Or See Claims Kicked Back
Do you know when to use the M2 occurrence span code for respite care services? Don&rsq...
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Hospice News:
OIG Review Finds Major Problems With Hospice Election Statements
The HHS Office of Inspector General continues to train a close eye on Medicaid...
Read more
Hospice News:
Be Sure To Include Facility NPI Too For Patients In SNF, Hospital
Don’t forget to report a service facility NPI when billing place of service HCPCS ...
Read more
Hospice Insider - 2014; Volume 7, Number 7
Know Your Facts:
Reviewers May Target You With Your Own Claims Data
CMS puts long LOS, high live discharge rates under its microscope. Medicare is analyzi...
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Regulations:
Hospice Payment Reform Waits Another Year
Quality reporting, CAHPS also addressed at recent industry conference. Centers for Med...
Read more
Compliance:
Don't Let Your Live Discharge Rate Become A Red Flag
Correction: CMS found 71 hospices had a 100 percent live discharge rate. You should in...
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Reimbursement:
Hospices Face Repayment Demands For Analgesics
Tip: Don’t delay in filing a dispute. Medicare’s new policy on prior autho...
Read more
Mergers & Acquisitions:
Acquisitions, Expansions Occur In Hospice Market
But closures are also taking place in the turbulent hospice environment. There’s...
Read more
Hospice News:
OIG Urges Congress To Require Proration Of DRGs When Patients Go To Hospice
Watchdog agency’s suggestion could curb hospital referrals. Referrals to hospice...
Read more
Hospice News:
MAC Rejects More Than 2/3 Of Long-Stay Hospice Claims
Can your records back up the patient’s six-month prognosis? If you’re subm...
Read more
Hospice News:
Register For Your Hospice Item Set Passwords
If you haven’t done much to prepare for HIS, you at least can register for your Us...
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Hospice News:
Infusion Pump Billing Sparks Claims Denials
If your hospice claims with infusion pump items are getting denied, you’re not alo...
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Hospice News:
More Charges Filed In High-Profile Passages Fraud Case
Two top executives at now-shuttered Passages Hospice, plus the hospice itself, are ...
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Hospice News:
Hospice Owner Faces Nearly 15 Years In Prison
A former hospice owner convicted of Medicare fraud has drawn a whopping 14.5-year prison...
Read more
Hospice Insider - 2014; Volume 7, Number 6
Regulations:
Expect Broader Coverage Expectations From Medicare, Proposed Rule Suggests
Your idea of what’s included in the hospice per diem may differ significantly...
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Reimbursement:
Hospices Slated For 1.3% Pay Increase In October -- Before Sequestration
No payment reform yet, but it’s on the horizon. Hospices’ financial burden...
Read more
Medical Review:
Can Your Claims Stand Up To Increased Scrutiny Of Patient Eligibility?
HIS, CAHPS to make your load heavier soon. Medicare may not want to appear to be penal...
Read more
Hospice News:
Hit Your Stride During Home Stretch Of HIS Prep
Use new tools from CMS to help you get ready for the new data gathering instrument. Yo...
Read more
Hospice News:
Know Where To Get Your Annual PEPPER Reports
The new Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER), with...
Read more
Hospice News:
Put This New ICD-10 Deadline In Your Datebook
Mark your calendar in red for Oct. 1, 2015. You have less than 18 months to prepare for ...
Read more
Hospice News:
Medicare Adoption Of Life Safety Code Updates Will Impact Inpatient Hospices
Inpatient hospices, take note: CMS is proposing updates to the Life Safety Code fire pre...
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Hospice News:
Sooner State Hospice Owner, Manager Face Medicare Fraud Charges
Allegedly lying in an audit has landed a hospice owner and general manager on the receiv...
Read more
Reader Question:
Handle Existing Meds This Way On Hospice Claims
MACs answer agencies’ questions about drug reporting in newly expanded Q&As. ...
Read more
Hospice Insider - 2014; Volume 7, Number 5
Reimbursement:
Are You Ready For The Hospice Drug Coverage Burden That Starts May 1?
The good news is that Part D plans have to take your word for it on unrelatedness &mdash...
Read more
Regulations:
Use CMS's Playbook For Prior Authorization Forms
CMS wants your feedback on a future required PA form for hospice patients’ drugs. ...
Read more
Coverage:
Include This Vital Element In Your Prior Authorization Documentation For Hospice Patients' Unrelated Drugs
Part D drug claims will get rejected, not denied, under new system starting next month. ...
Read more
Policies & Procedures:
Avoid Drug Billing Confusion By Reaching Out To Part D Plans From The Start
Tip: Collect hospice patients’ Part D plan information at admission. Expect the ...
Read more
Billing:
Hospices Shoulder Heavy Claims Burden
New drug reporting requirement is a killer. You need to be working with your facility ...
Read more
Hospice News:
ICD-10 Delay Gives Hospice Breathing Room
Tip: Don’t neglect ICD-9 training while you wait for the delayed ICD-10 codes to t...
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Hospice News:
OIG Announces $2 Million Amedisys Hospice Settlement
After the $150 million settlement with the Department of Justice that Amedisys Inc. agre...
Read more
Hospice Insider - 2014; Volume 7, Number 4
Fraud & Abuse:
OIG Investigates Hospice Services Provided In ALF Setting
Prevent ALF-related compliance trouble — before the feds coming knocking. After ...
Read more
Regulations:
Repeat Offender Billers May Face Door-Closing New Sanctions
CMPs, exclusion could be in store for hospices that don’t show improvement. If y...
Read more
Compliance:
Learn These Factors That Could Put You On The Recalcitrant Provider List
Your appeals success rate may save your bacon. If your MAC and CMS agree that you fit ...
Read more
Reimbursement:
HETS Deadline Pushed Pushed Back
CMS scrambles to get hospice functionality in place for new inquiry system. You won&rs...
Read more
Education:
Get Training On Hospice Compliance, Coding Requirements
Avoid citations related to staff competency requirements with this expert advice. You ...
Read more
Studies & Surveys:
Differences Between For-Profit, Non-Profit Hospices Focus Of Peer-Reviewed Study
New study keeps hot button issue of live discharges front and center. Referral sources...
Read more
Medical Review:
Don't Let Physicians Off The Hook On Hospice Narratives, MAC Stresses
Don’t Let Physicians Off The Hook On Hospice Narratives, MAC Stresses Warning: A...
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Hospice News:
CMS Presses 'Pause' On RAC Reviews
But the much feared Recovery Audit Contractors aren’t gone for good. You have on...
Read more
Hospice Insider - 2014; Volume 7, Number 3
HIS:
Tackle HIS Preparation With These 6 Steps
Make room for new HIS training sessions on your calendar. Even though it’s still...
Read more
Quality:
7 New Hospice Quality Measures
How well you prepare to fill out the new Hospice Information Set tool may influence your...
Read more
Regulations:
Get Ready For HIS Data Submission With These Pointers
What software do you plan to use? Collecting the clinical information you need for the...
Read more
Reimbursement:
Limit Your Respite Care Billing To 5 Consecutive Days
Claims with respite care stretching more than 5 days will RTP starting this summer. Ho...
Read more
Billing:
Gear Up For New Hospice Claims Data Reporting With New Info From CMS
The deadline for reporting new data is almost here. Medicare is offering some clarific...
Read more
Enforcement:
Hospice Co-Owner Charged With GIP Medicare Fraud
Bonuses focused on increased care levels, charges say. How you treat your employees co...
Read more
Disaster Planning:
New Emergency Preparedness Requirement On Deck
Does your emergency plan contain these 4 elements CMS wants? You’ve probably alr...
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Hospice News:
Know When To Cancel NOEs
When another hospice asks you to cancel, you need to do it, MAC says. If you have an e...
Read more
Hospice News:
Hospices Dispute Newspaper Allegations Of Gaming The Medicare Benefit
Hospices aren’t taking the allegations made against the industry by the Washington...
Read more
Hospice News:
Hop To HETS If You Haven't Already
Don’t forget: “Provider access to … eligibility systems will be termi...
Read more
Hospice News:
ALJ Delays Stretch Into Years
The wheels of justice grind slowly — and now will be even slower when it comes to ...
Read more
Hospice Insider - 2014; Volume 7, Number 2
Diagnosis Coding:
Choose Hospice Patients' Codes Carefully Under Increased Scrutiny
CMS’s focus on this area makes hospice coding more important than ever. Up until...
Read more
Fraud & Abuse:
High-Profile Newspapers Take Swings At Hospice Industry
Washington Post, New York Times take aim at hospices. Expect hospice payment reform to...
Read more
Referrals:
Nursing Home Survey Changes Stress Palliative Care Duties
Skilled nursing facilities may need your help now more than ever. You can help nursing...
Read more
Education:
Point Nursing Homes To These Survey Guidance Specifics On Palliative Care
More than one F-tag is involved in end-of-life care compliance for skilled nursing facil...
Read more
Hospice News:
Hospice Item Set Prep Should Start Now
HIS manual, training video coming. Your crash course in the new data collection tool f...
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Hospice News:
MedPAC Wants Hospice Rate Freeze
Hospices have often gotten a pass from the Medicare Payment Advisory Commission — ...
Read more
Hospice News:
Quality Data Website Open
You may now submit your Hospice Quality Reporting Program (HQRP) data for 2013 on CMS&rs...
Read more
Hospice News:
Study: Physicians Wait Too Late To Discuss Hospice
Physician preference, rather than patient preference, may be guiding hospice utilization...
Read more
Hospice News:
Hospice Surveys, GIP Feature In OIG Semiannual Report
The HHS Office of Inspector General hasn’t overlooked hospices in its latest semia...
Read more
Reader Question:
Get ALS Patient Coding Right With This Advice
Tip: Watch for unrelated conditions in hospice coding. Question: Our hospice patient h...
Read more
Hospice Insider - 2014; Volume 7, Number 1
Reimbursement:
New CMS Guidance May Raise Your Drug Costs
Prior authorization coming for all hospice patient drugs. CMS has been putting pressur...
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Compliance:
Noncompliance With New Drug Guidance Could Result In Fraud Charges, Takebacks
Hospice drug coverage isn’t just a reimbursement concern — it’s a comp...
Read more
Regulations:
Take 9 Steps To Avoid Drug Compliance Pitfalls
Pointer: Fine tune your formulary to walk the line between compliance and financial heal...
Read more
Billing:
Get Your Billing Straight For Looming Claims Data Deadline
MAC offers more info on burdensome new requirement. With all the new data you’ll...
Read more
Diagnosis Coding:
Get Ready To Shoulder More Hospital Costs
Your diagnosis coding will determine whether you pay for hospital care. CMS is taking ...
Read more
Hospice News:
Prepare For New Hospice Cost Report Form
Give CMS your 2 cents on the newest version of the form. You don’t have much tim...
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Hospice News:
You'll Have To Wait Longer For HETS Hospice Info
CMS still plans to get rid of the ELGA/ELGH system for looking up patient eligibility th...
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Hospice News:
MedPAC Eyes Recommendation To End Medicare Advantage Exclusion For Hospice Patients
Hospice patients’ exclusion from Medicare Advantage plans is under scrutiny by the...
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Hospice News:
Medicare Software Blocks Debility, Failure To Thrive, Dementia Diagnoses In Error
You’ll need to download a software patch if you’re using PC-ACE PRO32 v2.48....
Read more
Hospice News:
Hospice Providers Broaden Horizons With Name Changes
Providers looking to grow may want to consider rebranding as part of their marketing eff...
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Hospice News:
12-State Chain Merges Hospice Operations In New England State
Affiliated companies SolAmor Hospice and Life Choice Hospice have merged their Connectic...
Read more
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