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Hospice Insider
Hospice Insider
Hospice Insider - 2015; Volume 8, Number 12
Reimbursement:
New Nursing G Codes Finally Released For Hospice Reform
Track RN vs. LPN visits. If you want to avoid a major cash flow crunch in the New Year...
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Skilled Nursing Facilities:
Help Your SNF Partners Know Their New RAI Duties For Hospice Residents
Point out SCSA change in RAI Manual update. The Skilled Nursing Facilities your patien...
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Fraud & Abuse:
Fraud Trial Could Give Hospices Another Tool To Fight Whistleblower Suits
Jury finds claims false in first phase of trial. A trial that has caught the attention...
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Lawsuits:
Hospices Pay $12.6 Million In Recent Whistleblower Cases
Higher hospice care levels, aggressive marketing draw scrutiny. You can expect the num...
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Enforcement:
Authorities Crack Down On Hospice Fraud
Nurse imposter causes $2.3 million in false hospice claims. Whistleblowers aren’...
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Mergers & Acquisitions:
Hospices Combat Declining Reimbursement With Consolidation
‘Scale matters,’ says one market expert. Hospices are working hard to surv...
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Hospice News:
Time Hospice Cap Reporting To Your Advantage
Don’t wait too long to calculate your cap liability. Jan. 1 is looming large for...
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Hospice News:
Tell Referring Docs Advance Care Planning Rate Is Set
Physicians finally will have more financial incentive to discuss end-of-life choices, in...
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Hospice News:
Cost Report Changes For HHA-Based Hospices Posted
The Centers for Medicare & Medicaid Services has proposed changes to the home health...
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Hospice News:
Nursing Home-Hospice Partnership Highlights OIG's Blessing On Limiting Access
Baptist Retirement Community and Hospice of San Angelo in Texas are partnering, reports ...
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Hospice News:
2 Ohio Hospices Merge, But Keep Names For Now
Hospice of the Western Reserve and HMC Hospice of Medina County have merged. For the nex...
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Reader Question:
You Won't Get Off The NOE Timely Filing Hook For Your Own Billing Delays
Hospice argues it is processing time, not its own billing, that’s to blame. Ques...
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Hospice Insider - 2015; Volume 8, Number 11
Reimbursement:
Concurrent Care Demo Rolls Exceeds Size Expectations
First phase begins Jan. 1. Hospices hope a new pilot project could broaden the hospice...
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Reimbursement:
Hospices Question Whether Concurrent Care Demo Pays Enough
Plus: Did CMS drag its feet on the concurrent care pilot? A larger-than-expected respo...
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Finance:
HHA-Based Hospices Should Prepare For Revamped Cost Reports
Make your accounting changes immediately. If you’ve been paying attention to cos...
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Hospice Item Set:
Double-Check Your Hospice Item Set Submissions
Use free resources to increase your HIS compliance. If you leave an important step off...
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Education:
Get Training On CAHPS, Payment Reform, ICD-10
Also, check out Eli audio conferences on hospice basics. You can receive vital informa...
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Billing:
Know The HETS Rules To Improve Your Hospice Payment Accuracy
The devil is in the details when it comes to entering beneficiary data. Starting in Ja...
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Notices Of Election:
Get Your Notice Of Election Facts Straight Before It Costs You
Tip: Don’t let coding changes delay your NOEs. Every day you’re late filin...
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Hospice News:
Hospice Star Rating System On Its Way
CMS may post deadline outside of rulemaking, it says. Medicare continues to move forwa...
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Hospice Insider - 2015; Volume 8, Number 10
Diagnosis Coding:
You Must List All Of Patients' Diagnoses On Claims Starting Next Month
New requirement includes unrelated diagnoses, final rule stresses. Hospices are warily...
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Regulations:
Succeed Under Hospice 2016 Rule With These 5 Pointers
It’s time to kick your diagnosis coding documentation up a notch. Your payment w...
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Reimbursement:
Learn The Ropes For Hospice Payment Reform Billing
Catch: New nursing G codes won’t be out for a while. If you’re entering th...
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Billing:
Cut Troublesome Medications From Your Claims -- For Now
Will hospices’ drug costs go underreported? Hospices’ drug costs may go un...
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Cost Reports:
Cost Report Changes Afoot For Variety Of Hospice Types
Revisions follow in freestanding report’s footsteps. The Centers for Medicare &a...
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Hospice News:
High-Profile Trial In Hospice Whistleblower Suit Begins
One hospice chain’s sky-high live discharge rate is getting tested in court. A w...
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Hospice News:
National Chain Makes Big Hospice Buy
LHC Group Inc. has agreed to buy Halcyon Hospice LLC for about $58.5 million in cash, th...
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Hospice News:
2 Nonprofits In Florida Affiliate
The 31-year-old VNA and Hospice of the Florida Keys in Key West is forming an affiliatio...
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Hospice News:
Louisiana Hospice Acquires 2 Locations
EPI Group and Lafayette, La.-based Heart of Hospice have acquired for undisclosed terms ...
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Hospice News:
Hospice Closes Facility In Land Of Lincoln
Reimbursement constraints continue to take their toll on hospices. Hospice of Southern I...
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Reader Question:
Don't Let ICD-10 Delay Your NOEs -- And Cut Into Your Reimbursement
Switch to the new coding system is imminent. With the switch to ICD-10 almost upon you...
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Hospice Insider - 2015; Volume 8, Number 9
Reimbursement:
New Hospice Payment Reform Model Hits Jan. 1
Hospices will see 1.1% pay increase overall. In the New Year, figuring out how many da...
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Payment:
CMS Relents So SIA Will Apply To Nursing Home Residents Too
Prepare to change how you bill nursing visits. Your nursing home patients won’t ...
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Reimbursement:
Above-Cap Hospices Fare Worst Under New System
Whether your Medicare reimbursement goes up or down under the new rule depends on your p...
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Finance:
Hospice Providers Will Be Happy To Say Good-Bye To BNAF Cuts
Plus: Prepare for CBSA transition. Seven years of Budget Neutrality Adjustment Factor ...
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Regulations:
More Hospices Likely To Exceed Caps Under New Rule
Change to slice half a billion dollars from reimbursement. The Centers for Medicare &a...
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Diagnosis Coding:
Get Ready To Shoulder A Drastically Expanded Diagnosis Coding Burden
Hospices have to take on increased coding and ICD-10 almost simultaneously. New diagno...
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Hospice Item Set:
New 30-Day HIS Submission Deadline Starts In January
You’ll lose out on payment if you don’t meet the threshold. Nearly a quart...
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Hospice News:
Beware New Hospice Denial Codes Indicating NOE-Delaying ICD-9, ICD-10 Problems
Get to know three new reason codes that will point the way to diagnosis coding troubles ...
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Hospice Insider - 2015; Volume 8, Number 8
Reimbursement:
Beware Returned Claims When Meeting NOE Filing Deadline
Get answers to your burning NOE filing questions from one MAC. One MAC is offering a h...
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Referrals:
Physician Advance Care Planning Payment Could Boost Hospice
Medicare signals it’s ready to support advance care planning. Medicare appears r...
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Fraud & Abuse:
Lack of GIP Documentation Leads To $10 Million Settlement
Hospice agrees to 8-figure repayment after self-reporting. You’d better make sur...
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Compliance:
Publicly Traded Chain Under The Microscope -- Again
DOJ probes Amedisys, this time over hospice. The feds are combining two of their favor...
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Finance:
Hospices Open Inpatient Facilities Nationwide
From 3 to 16 beds, new facilities are serving their communities. GIP care may be on en...
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Appeals:
Prepare For Medicare Appeals Process To Change Drastically
Early stage appeals need to be more accurate, industry reps urge. Nearly everyone agre...
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Know Your Facts:
Appeals Timeframes Continue To Lengthen
Expect typical processing time for appeals decisions to exceed 540 days. Due to the ov...
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Mergers & Acquisitions:
Hospices Seek Affiliations In Increasingly Crowded Marketplace
Hospital closes hospice doors. Unreliable reimbursement and ever-increasing regulatory...
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Hospice News:
Hospices Finally Get A Break When It Comes to NOEs And Docs; NPIs
Doc number no longer a strict requirement, according to transmittal. For hospices that...
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Hospice News:
Examine These New Changes To The HIS Manual
If you missed CMS’s June 17 National Provider Call covering the updated Hospice It...
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Hospice News:
Tap Educational Resources For Pedes
If you’re looking for education materials relating to pediatric palliative care, t...
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Hospice News:
IACS Transition Drama Wraps Up
The troubled IACS-to-EIDM system transition is complete, CMS says. “CMS transition...
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Hospice Insider - 2015; Volume 8, Number 7
Reimbursement:
Medicare Claims System May Lighten Your Load For Service Intensity Add-On Billing
Plus: Quality reporting penalties clarified in Open Door Forum. Hospices had many ques...
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Strategy:
Waste No Time In Initiating Payment Reform Prep
Run the numbers to see how proposed rule will impact your bottom line. Your reimbursem...
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Studies & Surveys:
Hospice Costs Medicare More When Patients Reside In Nursing Homes
Hospice reduces hospital admissions and aggressive care, though. Hospice services furn...
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Studies & Surveys:
Hospice Patients' Diabetes Care Too Aggressive, According To New Study
Physicians should discuss scaling back or discontinuing diabetes meds, study recommends....
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Compliance:
Protect Yourself From These 5 Common Compliance Myths
Check out these misconceptions and why you shouldn’t keep believing them. You co...
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Compliance:
Don't Let Yourself Fall Victim To A Whisleblower Lawsuit
Employees often blindside owners, managers. A top compliance myth that has taken down ...
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Hospice News:
Tune In For New Hospice Item Set Training From CMS
Get vital details on the new HIS Manual. Hospices should mark their calendars for Hosp...
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Hospice News:
Are You Using Prior Authorization Form For Drugs?
The Centers for Medicare & Medicaid Services really wants you to use the P...
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Hospice News:
MAC Adds New Hospice Topic To Its Medical Review Hit List
Hospices aren’t just taking a beating in the popular press for high rates of live ...
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Hospice News:
Hospice Services Help Surviving Spouses Long After Care Ends, Study Shows
The Medicare hospice benefit may be under fire, but there’s no doubt it helps pati...
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Hospice News:
Review Your Discharge Ins and Outs
Brush up on your discharge responsibilities with a new booklet from the Centers for...
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Hospice News:
Health System Sheds Unprofitable Home Care, Hospice Agencies
Ambercare has acquired Gila Regional Medical Center’s Home Health a...
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Hospice News:
Say Goodbye To Extensions For ADRs
When you get a documentation request from your MAC or another Medicare entity (such as a...
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Hospice News:
Chicago Hospices Merge In Squeezed Market
Chicago-based Horizon Hospice & Palliative Care, Barrington, Ill.-based&nb...
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Reader Question:
Know When To File A Hospice Redetermination - And When Not To
Warning: Correcting the omission of the GW and GV modifiers may not be as easy as you th...
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Hospice Insider - 2015; Volume 8, Number 6
Payment:
Medicare Unveils Hospice Payment Reform Plan
Get ready for a 2-tier reimbursement model. Hospices with long-stay and nursing home p...
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Reimbursement:
Payment Reform Proposal Takes Hospices By Surprise
More complex methodologies discarded. If Medicare’s hospice payment reform isn&r...
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Regulations:
Further Hospice Payment Changes Loom On Horizon
Your claims and cost report data could determine the next phase of reform. If you were...
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Payment:
Watch Out For Wage Index Changes In 2016 And Beyond
Plus: Cap changes are in the works. With major payment reform taking center stage in t...
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Hospice Item Set:
Prepare For 30-Day HIS Deadline Next year
Submitting Hospice Item Set data within a month no longer just a guideline. If you can...
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Quality:
CMS Plans To Place Star Ratings On Hospices
Your HIS, CAHPS data will soon be on display The date may be unclear, but you can bet ...
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Diagnosis Coding:
Hospices Must Place Unrelated Diagnoses On Claims, New Rule Proposes
CMS accuses industry of gaming the system. Medicare’s proposed instructions for ...
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Hospice News:
Look Over Your Cap Statements Carefully For Sequester Impact
Demand letter doesn’t spell out details. Now that Medicare Administrative Contra...
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Hospice Insider - 2015; Volume 8, Number 5
Keep Your Eye On These Hospice Hot Spots
Half of hospice spending goes to long-stay patients, stats show. MedPAC thinks hospice...
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Know Your Facts:
LOS Is Down, But MedPAC Still Wants A Hospice Pay Freeze
Neuro conditions lead the pack for long stays. When you struggle day in and day out to...
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Payment:
MedPAC Turns Jaundiced Eye On For-Profits
Advisory body highlights LOS disparities. For-profit hospices have taken a beating fro...
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Benchmarking:
Watch For New SNF And ALF Data Targets In Your PEPPER Report
Access your benchmarking data — before regulators do. You should have an idea of...
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Business:
Hospices Continue Nationwide Trend Of Opening Inpatient Facilities
Will more inpatient availability help with feds’ concerns about GIP utilization? ...
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Hospice News:
Learn Notice Of Election Exception Lessons From One MAC's Examples
Tip: Pointing the finger at someone else won’t get you anywhere. Not sure how to...
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Hospice News:
Hospices Launch Class Action Lawsuit Against Cap Calculations With Sequester
A group lawsuit is now underway against cap calculations for 2013. After much confusion,...
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Hospice News:
Avoid, Clean Up 34923 Errors With This MAC's Advice
If your hospice claims are getting torpedoed by occurrence claim span (OCS) errors, Medi...
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Hospice News:
Don't Miss Hospice CAHPS May 1 Deadline
Take care to meet the May 1 deadline to turn in your hospice CAHPS survey vendor authori...
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Hospice News:
Learn These Hospice Payment Reduction Details
If you’re wondering exactly how the process will work when CMS docks your pay for ...
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Hospice News:
Watch Out For Retroactive Changes To Hospital-Based Hospice Cost Reports
Hospital-based hospices may have a tough time complying with CMS’s proposed deadli...
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Hospice News:
Court Shoots Down Suit On Hospice Religious Concerns
A federal court has dismissed an EEOC lawsuit against Fremont Regional Hospice in Canon ...
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Hospice Insider - 2015; Volume 8, Number 4
Reimbursement:
Submit Your Hospice Cap Amount By March 31
CMS will include sequestration in the hospice cap calculation — but not right away...
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Strategy:
Use These 8 Pointers To Make Your Hospice Cap Deadline
Class action lawsuit waits in the wings. You’ve got a few short weeks to comply ...
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Finance:
Use These MAC Tools To Avoid Hospice Cap-Related Penalties
Follow your MAC’s instructions to submit hospice cap by March 31. How exactly se...
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Fraud & Abuse:
Whistleblower Lawsuits Cost Hospices Big Bucks
Feds focus enforcement resources on hospice industry. Hospices’ efforts to stay ...
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Education:
Get Training On Hospice Diagnosis Coding, Live Discharges
Also, check out Eli audio conferences on quality of care regulation, eligibility. You ...
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Hospice News:
Know The Ropes To Avoid Facility NPI-Related Denials
Report a facility NPI for these 5 place of service codes. If Reason Code 34952 errors ...
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Hospice News:
Proportion Of Hospice Chains Providing Medicare Services Shoots Up Over Last Decade
If you need proof that the hospice industry is changing rapidly, look to a study publish...
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Hospice News:
Submit HIS Data Or Face 2017 Pay Reductions
The Hospice Item Set data you’re submitting now will affect your 2017 payment rate...
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Hospice Insider - 2015; Volume 8, Number 3
Payment:
Hospice Data May Result In Surprising Payment Reform Model
The final structure may not be what you expect. Skilled visits in the last days of dea...
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Fraud & Abuse:
OIG Puts Assisted Living Residents Receiving Hospice In Its Crosshairs
Hospice Compare is nearly on deck. If CMS heeds the OIG’s advice, you’ll b...
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Know Your Facts:
Skilled Visit Averages In Last 2 Days Vary Heavily Based On Day Of Week Death Occurs
Live discharges grow from 13% to 18% over decade. The Centers for Medicare & Medic...
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Reimbursement:
Hospice Payment Reform May Increase Methodology -- And Complexity -- Significantly
Certain routine days would pay more than $500 in one payment system iteration. Exactly...
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Regulations:
Sequestration Questions Dog Hospice Cap Calculations
Hospices wondering whether to include sequestration funds in their aggregate cap calcula...
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Billing:
Hospices Win One Concession On Notice Of Election Submission
Resubmit incorrect NOEs immediately, when errors fall into ‘billing’ categor...
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HIPAA:
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20...
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Hospice News:
Check Out Latest Version Of Hospice Drug Prior Authorization Form
CMS hints at making the form mandatory. You can now take a look at CMS’s latest ...
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Hospice News:
Hospital-Based Hospices Get Their Turn
If it’s not love at first sight with the revised cost report for hospital-based ho...
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Hospice Insider - 2015; Volume 8, Number 2
Reimbursement:
Get Ready To Make 2-Month Cap Window Or Face Payment Freeze
Line up your IACS access as soon as possible. Don’t forget you have a whole new ...
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Compliance:
Avoid These 6 Cap Reporting Pitfalls
Tip: Expect cap adjustment down the road. The learning curve on the new requirement to...
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Billing:
These 4 Notice Of Election Filing Exemptions May Save Your Bacon
Hint: Pointing the finger at staffing problems isn’t going to cut it. Is your ho...
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Studies & Surveys:
Nursing Homes And Hospices May Mix Better Than Authorities Think, Study Says
‘Crossover’ patients see longest stays, highest costs. Nursing home reside...
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Audits:
Say Hello To Your New Hospice Recovery Audit Contractor
RACs must meet new overturn cap. If you get hit by Recovery Audit Contractor review, i...
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HIPAA:
Hospice Paper Record Breach Plagues National Chain
Highway record dump makes the news. HIPAA penalties aren’t the only possible dam...
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Hospice News:
Get Ready To Defend Your Claims For 2 Nutrition-Related Groups
Focus on 6-month prognosis, MAC urges. Be sure your claims for hospice patients with t...
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Hospice News:
Keep Sequencing Up To Date For NOTR Submission Success
You’ll have a hard time making your Notice of Termination/Revocation filing deadli...
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Hospice News:
OIG Highlights Hospice Fraud Cases In Semiannual Report
Beware your financial relationships with your medical directors, suggests the latest HHS...
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Hospice News:
News Outlets Continue Criticism Of Hospice
Hospices continue to take a beating in the national press. Two new articles from The Was...
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Hospice News:
You Can Now Download CAHPS Exemption Form For Small Hospice Providers
Are you small enough to get out of new CAHPS requirements for hospice? If so, you’...
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Hospice News:
Multi-State Chain Adds West Coast Hospice Location
The Ensign Group has expanded its presence in Southern California. The Mission Viejo, Ca...
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Hospice News:
2 Non-Profit Hospices Join Forces In Buckeye State
Two Ohio non-profit hospices are teaming up. Hospice of Dayton and Cleveland-based Hospi...
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Hospice News:
Hospice Competition Heats Up In Florida
Numerous health care organizations are jumping at an opportunity to establish a hospice ...
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Hospice Insider - 2015; Volume 8, Number 1
Reimbursement:
Beware Cap Calculations Set To Include Sequestration Dollars Medicare Never Paid You
Overpayments will be based on reimbursement you never received, CMS confirms. Hospices...
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Hospice Item Set:
Hundreds Of Hospices Lag On HIS Submission
NOE billing, CAHPS also addressed in Open Door Forum. You’d better get on the st...
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Billing:
How It Works: Notice Of Election Billing
For a reminder on how you can qualify for an exception to the five-day Notice of Electio...
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Studies & Surveys:
Another Study Proves Hospice Saves Money
75 percent of non-hospice patients died in facilities vs. 14 percent of hospice patients...
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Lawsuits:
Hospice Employee Whistleblowers Rake In Millions
Feds keep the heat on hospice providers in recent weeks. A whistleblower in the case a...
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Fraud & Abuse:
Watch For New Ways To Yank Your Medicare Billing Privileges
Providers may live in fear of arbitrary decision-making by CMS. Take extra care with y...
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Compliance:
These 6 Factors May Make Or Break Your Billing Under New Anti-Fraud Rule
New providers will be at a disadvantage. Medicare will use these six factors to decide...
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Enrollment:
CMS Will Use New Criteria To Deny, Revoke Enrollment
Plus: Your prior Medicare debt history will count against you. In addition to the revo...
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Hospice News:
Master Tricky Drug Reporting On Hospice Claims With This MAC's Tips
Medication reporting errors mess up hospice claims processing. Starting back in April,...
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Hospice News:
OIG Keeps Pressure On Home Health, Hospice
Don’t expect the feds to ease up on hospices any time soon. In its latest “T...
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Hospice News:
Know What To Include In Your ADR Response
How much is too much, not enough or just right? One Medicare Administrative Contractor h...
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