Eli's Hospice Insider
VBID Hospice Carve-In Bears Down On Hospices In 14 States And Territories
PDF
Medicare has been reaching out about the Medicare Advantage change. Hospices affected by the Value-Based Insurance Design (VBID) Model need to understand their claims submission duties under the new program. So says the Centers for Medicare & Medicaid Services and its contractors in recent messages to providers. Medicare Advantage Organizations that are participating in the Value-Based Insurance Design (VBID) Model that includes hospice care were supposed to “communicate with hospice providers in the service area of their participating plans,” CMS said in Nov. 13 CR 12045. They were required send hard copy notifications in December. Double duty: “Hospice providers must submit claims and notices to participating MA plans to receive payment when their enrollees elect to receive hospice care,” the transmittal instructs. “Hospice providers must submit claims and notices to their Medicare contractor for informational purposes” as well, CMS adds. In addition to the MAOs mailing letters directly, MAOs and Medicare Administrative Contractors also are supposed to post the information on their websites, CMS says in the transmittal at www.cms.gov/files/document/r10458otn.pdf. HHH Medicare Administrative Contractor Palmetto GBA says it “mailed a letter and checklist to impacted hospice providers regarding participating plans, billing and claims processing information,” the MAC says in a post to its website. Palmetto has posted that state-by-state information on its website as well at www.palmettogba.com/palmetto/providers.nsf/ls/JM Home Health and Hospice~BVHQ8R4218. The documents offer information, such as which plans and affected areas are participating in the project, as well as instructions. Affected states and territories include California, Colorado, Georgia, Hawaii, Idaho, Indiana, Kentucky, Massachusetts, New Mexico, New York, Ohio, Puerto Rico, Utah, and Virginia. Meanwhile, planning for the second year is already underway. CMS has released the Calendar Year 2022 Request for Applications (RFA) for the VBID Model, and the applications are due April 16. CMS will hold a 2022 VBID Model and Hospice Benefit Component Overview Webinar Jan. 14 and office hours on Feb. 11. More information is at https://innovation.cms.gov/innovation-models/vbid
Eli's Hospice Insider
- Quality:
New Year Brings New Visits In Last Days Of Life Measure
Hospice Item Set update still awaits OMB approval. Data collection for a new hospice quality [...] - Reimbursement:
Another Year, Another MedPAC Recommendation For A Rate Freeze, 20% Cap
A lower average profit margin doesn’t change the pending advice to Congress. Even in the [...] - Cares Act:
Lost Fundraising Counts As Lost Revenues, HHS Clarifies
Get your facts organized for February reporting deadline. If you were adversely affected by the [...] - Benchmarking:
New Drug Claims Measure To Hit PEPPER Reports In 2021
See how you measure up in the spring. Hospices’ responsibility for their patients’ medications will [...] - Audits:
Incorrect Claim Determinations Abound In Latest OIG Audit
Plus: Semiannual report to Congress touts hospital pay proration for early discharges to hospice. The [...] - Managed Care:
VBID Hospice Carve-In Bears Down On Hospices In 14 States And Territories
Medicare has been reaching out about the Medicare Advantage change. Hospices affected by the Value-Based [...] - Hospice News:
Legislation Requiring More Frequent Surveys Pending In Congress
New requirements could block hospice access. The fraud and abuse spotlight continues to shine on [...] - Hospice News:
Medicare Updates Manuals To Reflect New Addendum Requirements
Medicare’s claims processing and benefit policy manuals have caught up to current hospice billing with [...] - Hospice News:
HOPE Tool Continues To Proceed
Hospice Outcomes & Patient Evaluation (HOPE) assessment tool testing appears to still be on track. [...] - Hospice News:
Care Compare Transition Complete
Hospice Compare is now a thing of the past. But its content isn’t. Publicly reported [...] - Hospice News:
New HHS Secretary On Deck
The changeover of presidential administrations is starting to hit close to home for health care [...] - Hospice News:
Rural County Loses Last Hospice Provider
Northwest Colorado Health has discontinued its home health and hospice services in Grand County, Colorado, [...] - Hospice News:
Threshold For Legal Review Rises In New Year
Among the rates rising in 2021 are the ones that qualify you for certain legal [...]