New Hospice Supplemental Medical Review Contractor Project

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The Centers for Medicare and Medicaid (CMS)’  Supplemental Medical Review Contractor (SMRC), Noridian Healthcare Solutions LLC, has posted a new hospice project, Hospice 90 Day Stay Notification of Medical Review.  This is a post-payment review of claims for Medicare hospice billed on dates of service from January 1, 2021 through December 31, 2021 for patients […]

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HHS Financial Report for 2021 Identifies Increases in Hospice Payment Error Rates

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Increases not “statistically significant”, according to HHS On an annual basis, the Department of Health & Human Services (HHS) issues a financial report that provides fiscal and high-level performance results that allow for the assessment of HHS’ performance over the previous fiscal year.  Last week HHS issued its FY2021 HHS Agency Financial Report (Report) containing an overview […]

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HHS Financial Report for 2021 Identifies Increases in Home Health, Hospice Payment Error Rates

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Increases not “statistically significant”, according to HHS On an annual basis, the Department of Health & Human Services (HHS) issues a financial report that provides fiscal and high-level performance results that allow for the assessment of HHS’ performance over the previous fiscal year.  Last week HHS issued its FY2021 HHS Agency Financial Report (Report) containing […]

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Improper Payment Rates for Home Health and Hospice Providers Decreased in 2019

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The improper payment rate for home health providers in 2019 dropped 5.5 percent to 12.1 percent, from last years’ rate of 17.6 percent. Non-hospital based hospices had an overall improper payment rate of 8.9 percent, a 2.1 percent drop from 11 percent in 2018 and hospital based hospices had an 18.9 percent improper payment rate, […]

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OIG Report Recommends CMS Use CERT Data to Identify High Risk Home Health Agencies

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CMS Remains Opposed to Using CERT Data to Identify Improper Payments, Prefers TPE & RCD The Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report pertaining to home health agencies (HHA), The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home […]

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In Light of New Evidence, NAHC Pushes OMB, CMS to Back off Review Choice Demonstration

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The National Association for Home Care & Hospice (NAHC) is calling on the Office of Budget Management (OMB) and the Centers for Medicare & Medicaid Services (CMS) to stop the planned Review Choice Demonstration (RCD) before it begins, in light of new evidence showing that “improper payments” in home health have been rapidly declining without […]

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CMS Stipulates Credentials of Medical Reviewers

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The Centers for Medicare & Medicaid Services (CMS) released Change Request 10909, which requires that the Medicare medical record review contractors ensure medical review audits are conducted by registered nurses, therapist or physicians. The requirement applies to the Medicare Administrative Contractors (MACs), the Comprehensive error Rate Testing Contractors (CERT), the Recovery Audit Contractors (RACs), the […]

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