Eli's Hospice Insider

Published on Thu Jan 21, 2016 PDF

Just because you didn’t report a hospice cap liability back in March, doesn’t mean you don’t owe money for fiscal year 2014. “It appears that the Medicare Administrative Contractors are in the process of updating cap computations, and any associated liabilities, for the 2012, 2013, and 2014 cap years,” says hospice consulting firm The Health Group in Morgantown, W. Va. “Hospices who have previously been notified of cap liabilities should be on alert for updated calculations and demand for repayment.”

Do this: “You should review your 2014 cap year computations using current beneficiary counts and payments to ensure that a liability does not exist,” The Health Group advises.

When CMS issued cap calculation instructions in 2014, finance expert Mark Sharp with BKD in Springfield, Mo., voiced concern over the difference in beneficiary counts and that reimbursement impact on the cap (see Eli’s Hospice Insider, Vol. 7, No. 11).

And don’t forget that CMS said it would include at least a portion of sequestration dollars that hospices never received in their 2014 cap calculations.

Good news: “We expect the 2015 submissions to include consideration of sequestration which was not included for the 2014 cap year,” The Health Group continues.

Take action: “Look at the status of any 2015 cap year liability now to better avoid any surprise overpayments in March 2016,” The Health Group recommends.