Eli's Hospice Insider

Published on Tue Nov 20, 2018 PDF

With the 2018 hospice cap reporting year ended as of Sept. 30, now’s the time for hospice providers to deal with the consequences.

Item #1: Hospices must report their cap level and any associated liabilities (overpayments that must be repaid) by Feb. 28, 2019, based on data obtained from the Provider Statistical & Review (PS&R) system no earlier than Jan.1, notes consulting firm The Health Group in Morgantown, West Virginia.

You can start estimating your cap liability now, since Medicare will have processed most 2018 claims by Oct. 31, offers The Health Group in its electronic newsletter. But “remember, the computed cap will continue to decline as patients served during the 2018 cap year continue to be served after September 30,” the firm explains. “Accordingly, any cap liability will continue to grow or a cap liability could result when none currently exists.”

Item #2: “Most hospices will be subjected to recalculation of Medicare cap liabilities by the MAC for prior cap years within the next few months,” The Health Group points out. “Cap liability calculations are subject to recalculation for a period of three (3) years from the last date at which time a cap liability (or increased cap liability) was determined. Hospices with prior year cap liabilities should be on alert for recalculation by the MAC and any requests for additional repayments.”