BREAKING NEWS – Home Health Review Choice Demonstration Extended 5 Years

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Today the Centers for Medicare & Medicaid Services (CMS) posted a notice on the Home Health Review Choice Demonstration (RCD) webpage announcing that the demonstration is being extended for five years.  The demonstration was scheduled to end on May 31, 2024, and the extension is not a surprise. States currently in the demonstration – Illinois, Ohio, […]

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Hospice Reminder:  The Deadline for Self-reporting of Your Aggregate Cap  is February 29

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Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2023 Cap year no later than February 29, 2024. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) timely may result in payment suspension. If you have a Cap-related liability, you are required to submit payment at the time you submit your […]

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Quarterly Credit Balance Reports Due Soon

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As a reminder, the Medicare Credit Balance Report for the quarter ending September 30th is due by October 30, 2022. The Centers for Medicare & Medicaid Services (CMS) requires participating providers to furnish information about payments made to them and to refund any monies incorrectly paid in a timely manner. The form CMS-838 is used to […]

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Home Health & Hospice MAC “Operation Collaboration” Summit Sessions Now Available Online

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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 […]

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Hospice MAC “Operation Collaboration” Summit Sessions Now Available Online

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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 […]

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Hospice Reminder: Deadline for Self-reporting of Aggregate Cap is March 1

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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 […]

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CMS Directs MAC Outreach to Hospices in MA VBID Demonstration Model Areas

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Beginning on January 1, 2021, through the VBID Model, participating Medicare Advantage Organizations (MAOs) can voluntarily participate in the Hospice Benefit Component of the Model, according to a November 13 transmittal (10458/CR 12045) from the Centers for Medicare & Medicaid Services (CMS).  During CY2021, nine plans will test coverage of Hospice as part of their […]

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COVID-19 Accelerated/Advance Payments Reminder — Get Ready for Repayment Withholds on Claims!

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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 […]

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Movement to HETS as Sole Source for Eligibility Queries on Horizon

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CWF: 3rd and later hospice benefit periods not calculating correctly In recent years, the Centers for Medicare & Medicaid Services (CMS) has taken steps to transition providers away from direct queries to the Common Working File (CWF) and toward the HIPAA Eligibility Transaction System (HETS) as the single source for beneficiary eligibility transactions.  Earlier this […]

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Review Choice Demonstration to Begin in Ohio on September 30, 2019

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The Centers for Medicare & Medicaid (CMS) announced today that the next state to participate in the Review Choice Demonstration (RCD) is Ohio and it will begin on September 30, 2019. In the same announcement, CMS also stated it anticipates 60-90 days between beginning the demonstration in the remaining states of Texas, North Carolina and […]

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CMS Announces Start Date for Review Choice Demonstration

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The Centers for Medicare & Medicaid Services (CMS) posted long-awaited information this morning about the next steps for its Review Choice Demonstration, which will begin in Illinois on June 1, 2019. As reported previously in NAHC Report, CMS announced its plans to modify the Pre-Claim Review Demonstration, now called Review Choice Demonstration, on May 30. […]

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