Medicare Administrative Contractor
MACs to Send Direct Mailing to Hospices Regarding MA VBID Hospice Component Model
In January 2021, the Centers for Medicare & Medicaid Services (CMS) initiated a four-year demonstration model (the MA VBID Hospice Component) under which eligible Medicare Advantage (MA) plans are permitted to offer hospice services as part of the benefit packages. For calendar year (CY) 2022, the MA VBID Hospice Component will expand such that plans […]
Read MoreMACs to Send Direct Mailing to Hospices Regarding MA VBID Hospice Component Model
In January 2021, the Centers for Medicare & Medicaid Services (CMS) initiated a four-year demonstration model (the MA VBID Hospice Component) under which eligible Medicare Advantage (MA) plans are permitted to offer hospice services as part of the benefit packages. For calendar year (CY) 2022, the MA VBID Hospice Component will expand such that plans in […]
Read MoreHome Health & Hospice MAC “Operation Collaboration” Summit Sessions Now Available Online
Earlier this year, the Home Health and Hospice (HHH) Medicare Administrative Contractors (MACs) – National Government Services (NGS), CGS and Palmetto GBA – hosted the 2021 Virtual HHH MAC Collaborative Summit titled, “Operation Collaboration: We are all in this Together”. The Summit was comprised of joint sessions that occurred on September 15 and 17, and […]
Read MoreHospice MAC “Operation Collaboration” Summit Sessions Now Available Online
In mid-September, the Home Health and Hospice (HHH) Medicare Administrative Contractors (MACs) – National Government Services (NGS), CGS and Palmetto GBA – hosted the 2021 Virtual HHH MAC Collaborative Summit titled, “Operation Collaboration: We are all in this Together”. The Summit was comprised of joint sessions that occurred on September 15 and 17, and MAC-specific […]
Read MoreCMS to Proceeed with Targeted Probe and Educate
The Centers for Medicare & Medicaid Services (CMS) has decided to continue to proceed with the Targeted Probe and Educate (TPE) medical review, which they resumed on September 1, 2021. (Please see NAHC Report CMS Resumes Targeted Probe & Educate.) Although, the Medicare Administrative Contractors (MACs) have been conducting limited medical review since August 2020, a […]
Read MoreCMS Resumes Targeted Probe & Educate
NAHC urges CMS to suspend TPE until the public health emergency ends The Centers for Medicare & Medicaid Services (CMS) indicated in an August 2021 MLNConnects newsletter that it will resume the targeted probe and educate (TPE) program that was suspended in March 2020 (as were most medical reviews) due to the COVID-19 public health […]
Read MoreCMS Extends Medical Review Dates
The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare Administrative Contractors (MACs) may now begin conducting post-payment medical review for later dates of services. On March 30, 2020 the Centers for Medicare & Medicaid Services (CMS) suspended most Medicare Fee-For-Service (FFS) medical review because of the COVID-19 pandemic. On August 17, 2020 […]
Read MoreHospice Reminder: Deadline for Self-reporting of Aggregate Cap is March 1
Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2020 Cap year no later than March 1, 2021. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) timely may result in payment suspension. (Note: the deadline is usually the last day of February but because February […]
Read MoreCOVID-19 Accelerated/Advance Payments Reminder — Get Ready for Repayment Withholds on Claims!
Medicare providers who qualified for accelerated and advance payments (AAP) during the COVID-19 Public Health Emergency (PHE) could have payments recouped in the next few weeks. In the interest of improving cash flow for Medicare providers during the PHE, the Centers for Medicare & Medicaid Services (CMS) issued guidance in late March 2020 allowing providers […]
Read MoreCMS Updates Targeted Probe & Educate Information
The Centers for Medicare & Medicaid Services (CMS) published updated targeted probe and educate (TPE) information contained in Chapter 3 of the CMS Program Integrity Manual (Publication 100-08) through Transmittal 10132/Change Request (CR) 11695. The updates incorporate information about TPE practices providers have experienced, but were not clearly outlined in the Manual. This update includes […]
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