Eli's Hospice Insider
More TPE Probes On Deck For Hospices
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The annual Comprehensive Error Rate Testing report may affect you more than you’d expect. Reminder: The CERT report released Nov. 30, 2018 showed that the Medicare payment error rate for hospices actually dropped 3 points to 11.7 percent in the latest period (see Eli’s Hospice Insider, Vol. 12, No. 1). But it also revealed that hospital-based hospices had the highest claims error rate of all provider types listed at 27.3 percent. Nonhospital-based hospices had the fifth-highest rate out of 11 provider types at 15.7 percent. The upshot will be more Targeted Probe and Educate review for hospices, it appears. In a question-and-answer set based on Palmetto GBA’s Oct. 4 Hospice Coalition meeting, the HHH Medicare Administrative Contractor says “we are planning some edits for later this calendar year due to CERT error rates increasing. We have several topics we are tracking at this point that are areas of concern.” Palmetto lists neurological disorders, live discharge rates, and increasing non-cancer length of stay (NCLOS) rates as examples of TPE targets. The Q&As are online at www.palmettogba.com/palmetto/providers.nsf/DocsCat/JM-Home-Health-and-Hospice~B6YP341300.
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