New at Noyce Consulting — hospice

Deductibles, 20 Percent Copays for Hospice and Home Health? That's the plan.

Hospital bed

"Oops, Congress changed that. Hospice isn't covered at 100% any more. Your husband's nurse will collect your 20% hospice co-payment, each visit, Mrs. Jones. And the Social Worker will bring your final bill on the first bereavement visit."

A little harsh, I know. And a bit unthinkable. But in essence, that's the plan promoted at a House Ways and Means Health Subcommittee hearing Oct 16, 2016.


Hospice Aggregate Cap Report & Overpayment Returns due March 31!

Man folding arms and smiling

Remember that hospices must calculate and report their estimated aggregate Cap to their Medicare Administrative Contractor (MAC) between three and five months after the October 31 each year. 

That makes the final deadline for the 2015 CAP report March 31, 2016. There's still time to comply. Don't risk payment suspension by filing late.


Recertify Agency Enterprise Identity Management (EIDM) Account or Lose Access

Fingers drumming
If security officers in every hospice and home health agency don't act by March 15, their agencies will be unable to comply with requirements to file cost reports (home health) and to calculate & report estimated aggregate caps (hospice) by March 31 if the hospice’s MAC does not provide the data directly to the hospice. 
Theresa M. Forster, VP for Hospice Policy & Programs, National Association for Home Care & Hospice circulated this message warning agencies how to avoid losing access to Provider Statistical and Reimbursement (PS&R) data necessary to report by ensuring all agency security officers act on the email received from their respective Medicare Administrative Contractor (MAC).

The Whats, Whens, & Hows of Repaying Agency-Discovered Overpayments to CMS

Woman with tablet

During a spot-check quality audit, you discover that the documentation in the patient record doesn't support the amount Medicare paid for the claim. Alarmed, you search the record for any misfiled documents and ask those involved with the patient's care if key information was documented correctly. After your frantic search it is clear that Medicare overpaid your agency for the services in a payment episode several months ago.

Yikes! You know the agency must repay Medicare. But isn't it too late? Was accepting the overpayment in the first place fraudulent?


Send Home Health & Hospice ICD-10 Coding Questions to the AHCC

Beth Noyce

Comments 4 Tags diagnoses, diagnosis, home care, hospice, ICD-10

Young man with laptop

Got questions about ICD-10 diagnosis coding for hospice or home health?

Email your queries to the Association for Home Health Coding and Compliance (AHCC) at: AHCCVoice@decisionhealth.com, Subject Line: ICD-10 Workgroup question.

Until recently, diagnosis coders had no option but to request official diagnosis coding guidance and clarification from CMS' designated coding gurus at the American Hospital Association's (AHA) "Coding Clinic." But hospice and home health agencies report receiving conflicting and/or inapplicable guidance that could lead to payment delays or claim denials.