Common Working File Edit Causing Incorrect Payments on Some LUPA Claims

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The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 12085 – Correction to Period Sequence Edits on Home Health Claims. The CR addresses an edit in the Common Working File that bypasses period of care sequencing on Low Utilization Payment Adjustment (LUPA) claims. Before the implementation of the Patient-Driven Groupings Model […]

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Full Common Working File Eligibility Sunset Due by December 2021

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Given the historical reliance of hospice providers on the Common Working File (CWF) for eligibility queries, the National Association for Home Care & Hospice (NAHC) has been closely following developments related to the Centers for Medicare & Medicaid Services’ (CMS’) planned phase out of access to the CWF for eligibility queries (see HERE and HERE). […]

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