Eli's Hospice Insider

Published on Tue Nov 22, 2016 PDF

Hospices aren’t in the high risk category — yet.

The feds are happy that their new revalidation procedures are whittling the number of Medicare providers. Make sure you aren’t in those ranks by staying alert to your revalidation deadline.

In a report earlier this year, the HHS Office of Inspector General praised the Centers for Medicare & Medicaid Services’ “additional efforts to revalidate all existing enrollments [that] yielded substantial revocations and deactivations of existing providers’ billing privileges.” The OIG also noted that “the revalidation process resulted in a much higher percentage of providers being deactivated than revoked,” according to a summary of the report, “Enhanced Enrollment Screening of Medicare Providers: Early Implementation Results.”

Enrollment data is trending in the right direction, the OIG concluded in the report. “After CMS implemented risk screening and site visit enhancements to strengthen the provider enrollment process, we found that providers submitted fewer enrollment applications to CMS in the postimplementation period,” the watchdog agency said.

Plus, “there was … an increase in the rate of applications that CMS returned to providers and a higher rate of approvals (lower rate of denials) among CMS’s enrollment determinations,” the OIG said.

Reminder: All hospices — new and revalidating — are in the “moderate risk” category, the OIG reviewed in the report. In contrast, new home health agencies are in the “high risk” category.

CMS kicked off its latest round of revalidations in March. If you miss your revalidation window, CMS may deactivate your Medicare billing privileges and make you enroll from scratch.

Tip #1: You can look up your revalidation due date in PECOS or in CMS’s new revalidation lookup tool at https://data.cms.gov/revalidation, HHH Medicare Administrative Contractor National Government Services told providers earlier this year. NGS also sends out revalidation notices in yellow envelopes, the MAC noted. However, other MACs use email only, CMS noted on its revalidation website at www.cms.gov/medicare/providerenrollment-and-certification/medicareprovidersupenroll/revalidations.html.

Tip #2: “Generally, the due date will remain with the provider/supplier throughout subsequent revalidation cycles,” NGS told providers. “So you will not have to wonder about the due date the next time you need to revalidate.”

Beware: Don’t send in your application early. “Unsolicited applications received six months prior to the revalidation due date will be returned to the provider,” NGS reminded.