Due Now: Credit Balance Reporting now due for the Quarter ending 9/30/2023regardless of whether any credits need to be reported. What to Submit: The one-page Credit Balance Report – Form CMS-838. Ensure that it is signed by an authorized representative. It may be necessary to submit additional Credit Balance Report Detail pages. When To Submit: …
Tag: hospice
Hospice Surveys & Complaints
When is the last time you entered a complaint in your grievance log? One of the core standards of focus for hospice surveyors is §418.52(b)-Exercise of rights and respect for property and person. The interpretive guidelines for this standard state that a “grievance is a formal or informal written or verbal complaint made to any…
Public Health Emergency and Hospice
The end of the COVID-19 Public Health Emergency on May 11th requires hospice organizations to examine their current practices. The waivers and flexibilities put into place to ease burdens on hospices will be coming to an end. To avoid survey deficiencies, it’s important to know when compliance to the affected Conditions of Participation is expected. A…
State Operations Manual (SOM) for Hospice – Appendix M and subsequent revisions to the Hospice Basic Surveyor Training
On January 27, 2023, the Centers for Medicare and Medicaid Services (CMS) released Memo# QSO-23-08-HOSPICE related to revisions in the State Operations Manual (SOM) for Hospice – Appendix M and subsequent revisions to the Hospice Basic Surveyor Training. These revisions take effect immediately and are related to the focus by CMS on the quality of…
Hospice Final Rule Implementation
Just over the horizon, October and everything pumpkin is approaching. This means the implementation of the hospice final rule for FY 2023–beginning on October 1st. This year’s final rule includes a rate increase of 3.8% for those hospices who submit required quality data. For those who don’t comply, a 2% payment penalty is assessed to…
Claim Denial
Nothing can be quite as deflating to hospice leadership and staff as these words. Whether hospices are in the midst of TPE or other medical review, a common denial reason is failure to support the six-month terminal prognosis. Diagnosis alone may not suffice in establishing the physician’s prediction of the patient’s life expectancy. Hospices with…
Hospice Certification
As scrutiny of hospice organizations increase, it’s particularly important for hospices to ensure their certifications and recertifications of terminal illness meet all required elements. In the 2021 Medicare FFS Supplemental Improper Payment Data report of improper payments, the top cause for error was “insufficient documentation of the physician’s certification/recertification”. A few short months from now,…
Hospice Benefit Eligibility
Just last month, the Office of Inspector General (OIG) announced its intent to perform a nationwide review of hospice beneficiary eligibility. This action was in response to identified recent negative findings during individual provider audits by the Office of Audit Services. In their audits, they found a pattern of patients who did not meet eligibility…
Hospice Election Statement Addendum
October 1st marked the beginning of the hospice fiscal year and implementation date of some changes detailed in CMS’ Hospice Final Rule. One particular modification has to do with the Hospice Election Statement Addendum. Hospices are now required to include a “date furnished” on the addendum and this date must also be recorded in the…
Hospice Final Rule
The hospice final rule for Fiscal Year (FY) 2022 was issued on July 29th. This 226 page document–CMS-1745-F–addresses a number of changes including the hospice wage index, payment rates, and aggregate cap amount for FY 2022. Specifically, hospices who submit quality data will receive a 2% raise in payment rates. Hospices who do not submit…
