In the midst of tremendous challenges facing the hospice industry, the Centers for Medicare and Medicaid Services (CMS) has issued guidance to Medicare Administrative Contractors (MACs) and Qualified Independent Contractors (QICs) that is likely to have a positive effect on hospice providers. The guidance from CMS directs MAC and QIC reviewers to limit the redetermination and reconsideration review to the reason(s) the claim was initially denied for all post-payment reviews.
By now you have hopefully heard about the changes regarding the hospice Notice of Election (NOE), Notice of Termination/Revocation (NOTR), and processes for identifying/changing the attending physician that take effect October 1, 2014. This blog post details these changes and identifies best practices to comply with the changes. At the conclusion of this post is a downloadable PDF that you can share with everyone who needs this information.
The hospice industry is experiencing unprecedented payment-related scrutiny by the Centers for Medicare and Medicaid Services (CMS) to ensure proper payment for the provision of the Medicare Hospice Benefit. In response to the scrutiny, hospice organizations across the country are asked to submit documentation to demonstrate compliance with the Medicare conditions of payment through clinical record documentation.