Eli's Hospice Insider

Published on Tue May 17, 2011 PDF

Hosipices have received some good news -- one nagging claims system error is resolved. Top on the list of hospices' claims submission problems is a glitch with hospice notices of election (NOEs).

The problem: "On Notice of Elections (NOEs) (type of bill 82A or 81A), hospice providers are not able to access the NPI field for the OTH PHYS line on the FISS Claim Page 03," regional home health intermediary Cahaba GBA says on its website.

"Hospice notices of election (NOE) transactions require the attending physician and the OTH physician," explains HHH MAC subcontractor National Government Services in an e-mail to providers. "Therefore, NOEs are rejecting with reason code E9351."

The solution: Eventually a system fix will resolve the problem. But HHH MAC Palmetto GBA offers this stopgap solution: "The approved workaround is for providers to leave the 'OTH PHYS' NPI field blank."

If your non-cancer length of stay rates for hospice patients vary widely from the norm, you can expect extra scrutiny. HHH MAC Palmetto GBA has released its most recent NCLOS rates.

The condition with the longest average length of stay in Palmetto's service area is Alzheimer's, with an average of 208 days, according to Palmetto's NCLOS data from the last six months of 2010. That's far ahead of the next runner-up, ALS with an average of 167 days.

The shortest average stays were for Renal (42 days), Other Digestive (60), and Liver (62), Palmetto says in its most recent data compilation. Palmetto breaks out its NCLOS data by state and policy. All hospice providers submitting claims to Palmetto receive their individual NCLOS rate information through the U.S. mail six to 12 weeks after the closure of the measurement period, Palmetto explains. "This precludes the need to submit a written request for this information, as previously required,"  the HHH MAC says.

For a free link to and PDF files of Palmetto's NCLOS data, e-mail editor Rebecca Johnson at rebeccaj@eliresearch.com with "NCLOS Data" in the subject line

National chain Amedisys Inc. has agreed to pay about $125 million for Boston-based Beacon Hospice Inc. Beacon has 23 free-standing locations and one inpatient unit in Massachusetts (11), Maine (5), New Hampshire (5), Rhode Island (2) and Connecticut (1), Baton Rouge, La.-based Amedisys says in a release.

Beacon had about $80 million in revenues in 2010, Amedisys says. "Many of Beacon's hospice locations [match] the market presence of our existing home health care centers," Amedisys CEO William Borne says in the release.

Beacon has an average daily census of about 1,300, Amedisys Hospice Care's James Robinson says in the release. "The addition of Beacon will increase the number of hospice patients under our care by nearly 40 percent," Robinson says.

On April 14, President Obama signed into law legislation removing the extra 1099 tax reporting requirements. Small businesses are cheering the move.

Background: The Internal Revenue Service requires businesses to issue a Form 1099 to individuals or unincorporated businesses paid $600 per year for services rendered. The Affordable Care Act health care reform law enacted last year would have expanded 1099 reporting by requiringbusinesses to report payments for goods as well as services, and extended 1099 reporting to transactions between businesses as opposed to limiting requirement to payments to individuals.