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Hospice Insider

Combat These Common Denial Reasons With 3 Expert Pointers
MAC reveals threshold for getting off TPE review. Could you survive if half your claims g... Read more
Check Your Election Statement Form Against This List
Tip: Your statement must stress the palliative versus curative option. Medicare probes wi... Read more
Medical Review:
Master TPE Basics With Info From CMS, MACs
Warning: Failing TPE can lead to RAC scrutiny or worse. Now that Medicare had decided to ... Read more
Head Off Fraud Allegations With These 4 Pointers
Whistleblower suits spark $75 million payout. Financial pressure isn't the only kind hosp... Read more
Hospice News:
HEART Preparation Moves To The Next Phase
You're likely one step closer to a required assessment tool. In its final rule for 2018 h... Read more
Hospice News:
Speed Your Appeals With New Low-Volume Alternative
If you're not a Medicare appeals frequent flier, you now have an option that may expedite ... Read more
Hospice News:
Hospice Compare Refresh Data Cemented
Hospice Compare's next data refresh will be in February, but the data for supporting that ... Read more
Hospice News:
Credit Balance Reporting Questions Persist Over Billing Corrections
Not sure what to do about your credit balance reporting duties if you didn't submit Routin... Read more
Hospice News:
See How Your State's Medicare Spending Compares
Interested in seeing where your state's spending is trending? You can check out recently r... Read more
Hospice News:
Prevent Wayward Appeal Letters With This Check
Be sure your address in the Fiscal Intermediary Shared System (FISS) and the Natio... Read more
Consider Whether You Should Seek RHC, SIA Payment Adjustments
It's up to you to seek your rightful reimbursement for payment errors under reform. The c... Read more
Follow These Dos And Don'ts For Hospice Reform Payment Corrections
Including transfer patients or patients' PHI are both no-nos. The new easier method to su... Read more
You Can't Submit NOEs Electronically Without This Crucial Item
Take a look at the NOE submission requirements in the recently released NOE companion guid... Read more
Medical Review:
Surprise: Targeted Probe & Educate Applies To You, Too
Long-stay claims first under the TPE microscope. If you thought you were dodging a medica... Read more
Studies & Surveys:
Hospice Use Saves Money, According To Recent Studies
Are you doing enough to address caregivers' problems? End-of-life spending, obese patient... Read more
Hospice Notes:
Live Discharge Rate Attention Dogs Hospices
News outlets focus on possible gaming. The hospice industry's ratio of live discharges is... Read more
Hospice Notes:
Ace Sequential Billing Requirements For Billing Success
Failing to follow sequential billing rules for hospice is not only cash flow-draining, it'... Read more
Hospice Notes:
Preview Error Won't Show On November Hospice Compare Refresh
If your Hospice Compare preview report for the next refresh looks a little weird, it may b... Read more
Hospice Notes:
Share Your Medicare Improvement Ideas Before Thanksgiving
The change in presidential administrations may give you a chance to offer big-picture sugg... Read more
Hospice Notes:
Medicare Termination Notices Hit Cyberspace
The Centers for Medicare & Medicaid Services has started publishing termination notice... Read more
Hospice Notes:
Unraveling Of San Diego Hospice Legacy Continues
San Diego-based Scripps Health, the health system that bought high-profile San Diego Hospi... Read more
Hospice Notes:
Medicare Ramps Up Beneficiary Card Transition
Medicare won't start sending out its new beneficiary cards until next April, but it's alre... Read more
Hospice Notes:
Seniors Continue To Patrol For Medicare Fraud
Don't be surprised if you get some pointed billing questions from your patients. The HHS O... Read more
Hospice Compare Launch Shows Lagging Scores For Pain Assessment
Medicare’s quality measure comparison website is now up and running. If you’v... Read more
Know The 7 Hospice Compare Measures From Treatment Preferences To Bowel Regimens
Plus: Eight more CAHPS measures are coming this winter. Unless you don’t meet the d... Read more
Emergency Preparedness:
Hurricanes Underscore Importance Of Emergency Preparedness Compliance
Know which waivers apply to you. Home care and hospice providers work on their emergency ... Read more
Emergency Preparedness:
Don't Get Caught Unprepared: Tap These Emergency Preparedness Resources
Check out the EP rule requirements. Hospice providers affected by Hurricanes Harvey and I... Read more
Hospice: Check QIES To See Whether 2% Cut Will Hit You Oct. 1
Are you going to be facing a reimbursement cut next year that you don’t even know ab... Read more
Roster Billing On The Horizon For Payment Reform Corrections
If you wait, you may have less work. Hospices hoping for a little bit of help from Medica... Read more
Fraud & Abuse:
Hospice Fraud Case Takes Center Stage
Physician receives 3 years in hospice fraud scheme. Cases like the one for Angel Eye Hosp... Read more
Hospice Notes:
Drug Spending Catches OIG's Attention
Watchdog agency adds another hospice topic to its Work Plan. A new HHS Office of Inspecto... Read more
Hospice Notes:
Your Accreditation Survey Details Will Stay Private — For Now
If you’re accredited by a third-party organization like JCAHO or CHAP, you don&rsquo... Read more
Hospice Notes:
Take These Precautions When Reporting Your Cap
Avoid a payment disruption by taking a few extra steps with your hospice cap reporting, on... Read more
Hospice Notes:
The Rise Of Corporate Investors Leads To Conflict Of Interest Problems, Study Suggests
Patient steering is back on the radar, thanks to a new study about corporate investors in ... Read more
Hospice Notes:
Get Your GEMs Before They're Gone
The effective date for ICD-10 2018 code updates is fast approaching on Oct. 1, and for the... Read more
Medicare Payment Rates To Increase 1% In 2018
Rates essentially unchanged from proposed rule. No payment surprises unfortunately doesn&... Read more
Physician Documentation Questions Worry Hospices
Hospice admission assessment can’t be basis for eligibility, rule says. Don’t... Read more
Don't Get Your HEART Set On The Current Payment System
Coming assessment tool may turn your reimbursement world upside down — eventually. ... Read more
There's No Rush On HEART, CMS Pledges In Rule
Extensive pilot testing is on the agenda, Medicare says. If implementing a new, expanded ... Read more
Medicare Gears Up For Electronic Notices of Election At Long Last
You’ll need to jump through some hoops to be able to submit NOEs electronically. Ho... Read more
Hospice News:
Study Claims Link Between Live Discharge Rate, Profitability
The feds have another reason to focus on this statistic. You may want to take a second lo... Read more
Hospice News:
Include A Second NPI In This Circumstance Or Face Returned Claims
You’ll need to know the NPIs of the facilities in which your patients reside when re... Read more
Hospice News:
OIG Encourages Anonymous Fraud Reporting
Whistleblower lawsuits are costing hospice providers big. But disgruntled employees don&rs... Read more
Must You Adjust Claims Paid Incorrectly Under Payment Reform? It Depends On You
Questions still remain about payment reform corrections. Hospices annoyed that Medicare i... Read more
Hospice Item Set:
Use These New Pointers From CMS To Master HIS Item A1400
Here’s how to handle Medicare Advantage plans on this tricky question. Some of the ... Read more
Beware Whistleblower Lawsuits Triggered By These Red Flags
Two new settlements put hundreds of thousands of dollars in relators’ pockets. If y... Read more
Hospices Catch A Break With Cap Proration In Transition Year
It may be time to appreciate some good news for once. With so much going on in the hospic... Read more
Use Emergency Preparedness Interpretive Guidelines To Get In Compliance Before It's Too Late
Warning: You must conduct testing before November. If you’ve been waiting (against ... Read more
Hospice News:
Keep Up With Your Peers By Downloading Your PEPPER
Your state may be the one where 100% of hospices have downloaded their free benchmarking r... Read more
Hospice News:
Note This HQRP Improvement In Proposed Rule
The hospice payment proposed rule for 2018 includes new duties and burdens for hospices, b... Read more
Hospice News:
MAC Shares Non-Cancer LOS Stats
Check out whether your length of stay numbers are making you stick out like a sore thumb t... Read more
Hospice News:
Share Your Thoughts With CMS On Physicians & Hospice
Want to give Medicare your two cents about the physician’s role in hospice care? Now... Read more
Hospice News:
Check For Glitch Fallout
A claims processing error at one HHH Medicare Administrative Contractor may mean more work... Read more
Hospice News:
Don't Share Survey Results Publicly, Accrediting Body Urges CMS
If you don’t like the idea of your accreditation survey results going public, you ar... Read more
Hospice News:
Texas Company Makes Buy In-State
In Houston, Traditions Health Care Holding Company has acquired Hallmark Hospice through i... Read more
Hospice News:
SSN-Free Card Implementation Around The Corner
The April 2018 start date for use of Medicare cards with no Social Security Numbers on the... Read more
Reader Question:
Whistleblowers Receive Cool $10 Million In Fraud Settlement
Long-term care company Genesis Healthcare Inc. has agreed to pay $53.6 million to settle s... Read more
Use This Info To Make Your Judgement Call On Whether To Reprocess Hospice Claims
Will the money from adjusting wrongly paid claims be worth the effort? It may not be your... Read more
OIG Outlines Latest Hospice Red Flag Areas
Increasing medical review, regulatory burdens ahead, report signals. With the HHS Office ... Read more
Payment Reform Doesn't Go Far Enough, OIG Maintains
CMS hasn’t heeded OIG’s recommendations in restructuring payment, watchdog age... Read more
Know Your Facts:
Hospice Diagnosis Code Reporting Improves
Some of the stats CMS cites in the 2018 proposed payment rule may surprise you. The Cente... Read more
Demonstration Projects:
Will Concurrent Care Demo Changes Help Participation?
Education for next phase of MCCM should begin soon. Loosening MCCM’s eligibility cr... Read more
Know Your Hospice Compare Deadlines
Don’t confuse this winter with next winter. You’ve got until June 30 to revie... Read more
Hospice News:
Mind Your Transitions, Care Levels In Anticipation Of New Quality Measures
Keep an eye on this development from the 2018 rule. Just because CMS didn’t officia... Read more
Hospice News:
Survey Results That Are Now Private May Soon Go Public
Getting your Medicare certification through an accrediting organization (AO) may no longer... Read more
Hospice News:
OIG Rehashes Kindred's $3.1 Million Settlement
Hospices don’t get as much space as some other provider types in the HHS Office of I... Read more
Hospice News:
FBI Raids Hospice And Its Physician Owner In Lone Star State
FBI agents and Texas State Troopers raided the Houston and Beaumont offices of Harbor Hosp... Read more
CMS Dials Back Hospice Pay Increase For Next Year
Rebasing cuts could be in your future. You’ll have more quality and other regulator... Read more
Do You Want To Depend On Referring Physician Documentation?
Change CMS is considering could throw up major access roadblocks. Compared to their home ... Read more
5-Star Ratings In The Pipeline For Hospice Compare
Plus: Take a look at your Hospice Compare measures. Fun in the sun isn’t the only t... Read more
Benefit From The Feds' PEPPER Push
Learn from these hospices’ PEPPER examples. If you think diving into your free PEPP... Read more
Hospice News:
Know The NOE Corrections Ropes To Avoid Losses
How much do you know about election statements? While some Notice of Election losses may ... Read more
Hospice News:
Check Out These Medicare Demographic Predictions
Projections for Medicare spending are going up, and that means you should prepare for your... Read more
It's Not Over Til It's Over: RHC Counting Glitch Not Fixed Yet
And you’re going to have to make your own SIA corrections, CMS revealed. If you tho... Read more
Hospice Item Set:
Focus On Accuracy Of New HIS O Items
4 of the 7 new HIS items can be checked against your claims. As you get used to the revam... Read more
Medical Review:
GIP, RHC Services Go Under The Medical Review Microscope
Make sure your documentation supports your claims. Hospices are getting hit with scrutiny... Read more
MedPAC Recommends Rate Freeze For Hospice Pay, Again
Declining profit margin, LOS doesn’t matter. Medicare should spend less on hospice,... Read more
Hospice News:
Hospices Explore Partnering With Paramedics
Can paramedics help keep hospice patients out of the ER? Hospices looking for ways to red... Read more
Hospice News:
Wait For This MAC Letter Before Appealing RAC Denial
Hospices are waiting to see what topics get approved for audit from the new home health- a... Read more
Hospice News:
Beware Inaccurate Hospice Reports
If you’ve run any Hospice-Level Quality Measure Reports or Hospice Patient Stay-Leve... Read more
Hospice News:
Mark This HQRP Schedule Change In Your Calendar
If you signed up for the Hospice Quality Reporting Program training webinar from CMS on Ap... Read more
Hospice News:
New CMS Administrator Confirmed
Hospices wondering if Seema Verma’s Indiana Medicaid program experience would be imp... Read more
Hospice News:
President's Budget Calls For More Fraud Investigations
President Trump’s budget blueprint does not address Medicare spending exactly, but i... Read more
Hospice News:
Avoid Claims Returns By Using Correct Nursing G Codes
Don’t let common G code confusion slow your cash flow. The problem: HHH Medica... Read more
Hospice News:
HHH M&A Market Rose In 2016
Merger & acquisition activity in the home health and hospice market increased 12 perce... Read more
Hospice News:
Learn More About Your RAC
Get some insight into what your new home care and hospice-specific Recovery Audit Contract... Read more
Hospice News:
Publicly Traded Company Partners With West Virginia Hospital
LHC Group Inc. has entered into a home health and hospice joint venture with Pleasant Vall... Read more
Hospice News:
Chain Adds A Location In Florida
VITAS Healthcare’s new office in Pensacola, Fla., is its forty-fifth location, the P... Read more
Hospice News:
Where Does Your State Stand In Medicaid Fraud Enforcement?
It’s not just federal authorities who will be scrutinizing you for fraud. State Medi... Read more
Should You Pay Cap-Based Overpayment Demands?
Pre-2013 cap recalculations plague hospices, but maybe not for much longer. Whether you w... Read more
Pay Reform Continues To Give Hospices Billing Nightmares
Plus: Use these free HQRP training resources. Snafus related to billing hospice Routine H... Read more
Fraud & Abuse:
Hospices Fight Fraud Rep In Wake Of Texas Overdose Allegations
CHC upcoding features in fraud case. Sixteen people have been indicted on hospice Medicar... Read more
Make Sure Your Medical Director Relationships Can Pass Scrutiny
Physicians’ misdeeds went far beyond just accepting kickbacks, feds allege. A high-... Read more
Drug Use, Luxury Cars Help Determine Hospice Owner's Sentence
$27 million in restitution ordered in addition to lengthy prison stay. The hits just keep... Read more
HHS Secretary, CMS Administrator Confirmed
What’s in store? Former Congressman Tom Price has been confirmed as Health and Huma... Read more
Hospice News:
Try That SIA Adjustment Again
Payment reform billing tangle continues. It may not be a shocker that yet another fix for... Read more
Hospice News:
Master New G Code Usage With This MAC's Chart
To get your skilled nursing coding right, you’ll need to ignore part of the descript... Read more
Hospice News:
Beware New Edit Focused On Notice Of Election Dates
If your billing staff is sloppy with the dates of Notices of Election, you’ll start ... Read more
Watch Out For Pre-2013 Cap Overpayment Demands
Long-stay patients may be keeping your cap liability an open question. You may think y... Read more
Protect Your Reimbursement From Cap-Based Reopenings With These 5 Pointers
Tip: Don’t overlook another critical figure that might change in your reopened cap... Read more
Are You Aware Of The Latest Hospice Cap Reporting Changes?
This year’s cap deadline is fast approaching. You might be worried about previou... Read more
Influential Advisory Body Comes Out Against Hospice Pay Increase — Again
Dwindling profit margins don’t seem to matter to MedPAC. Some critical data indi... Read more
Are You Complying With The 60-Day Rule For Overpayments?
You’re still on the hook for six-year-old overpayments. With all the changes and... Read more
Your Understanding Of 'Identification' Is Critical For 60-Day Rule Compliance
‘Reasonable diligence’ shouldn’t take more than 6 months. Ignoring &... Read more
Hospice News:
Hospice Compare Date Slides To Late Summer
Public comparison tool debut is still just around the corner. You’ve got a littl... Read more
Hospice News:
Watch Out For This HIC Roadblock
A simple data entry problem or incorrect information may be leading to difficulty checki... Read more
Hospice News:
New Survey & Cert Memos Address Life Safety Code Issues
Hospices with inpatient facilities can’t afford to overlook two new Survey & C... Read more
Hospice News:
Say Goodbye To ZPICs, PSCs, And MICs, Hello To UPICs
You may have a new set of reviewers looking over your shoulder. CMS has awarded the Nort... Read more
Hospice News:
Alert Your Referring Docs To 2017 Chronic Care Management Changes
If your physician referral sources bill for Chronic Care Management, you might want to s... Read more
Hospice News:
Make Sure You're Using The Updated Form I-9
If you’re not using the latest version of this employment form, you’re riski... Read more
Use These Tools To Focus On Quality This Year
Check out these new resources from Medicare. Now is the time to make sure your quality... Read more
Refresh Yourself On Your 7 Existing Quality Measures
Are you sure your scores are up to snuff after years of collecting data for these items?... Read more
Expect Big Changes Ahead For PACE Programs
Shifting PACE market may look familiar to hospice industry veterans. A revamp of Medic... Read more
Should PACE Learn Lessons From Hospice Journey?
Influx of for-profit PACE providers may be in the works. While some parties are leery ... Read more
Fraud & Abuse:
Years-Long Hospice Patient Featured In Whistleblower Lawsuit
Do your employees feel like you’re listening to their compliance concerns? If yo... Read more
Hospice News:
MAC Issues New Signature Deadline Policy
CGS rescinds hasty policy interpretation. Put one more time point on your list of dead... Read more
Hospice News:
Compensate For This Vaccination Billing Snafu
Add one more Medicare billing system glitch to your list — and an action item to c... Read more
Hospice News:
IRS Mileage Rate Lowers Just A Hair For 2017
If you base your travel reimbursement to employees on the IRS’s standard mileage r... Read more
Hospice News:
Regional Chain Acquires Hospices In Ohio, Kansas
Jackson, Mich.-based Great Lakes Caring Home Health and Hospice has purchased Grace Hosp... Read more
Hospice News:
For-Profit Chain Finalizes Joint Venture, Includes 10 Hospice Locations
LHC Group Inc. and Brentwood, Tenn. based LifePoint Health have finalized the formation ... Read more
Hospice News:
Update Your Calendar With Rescheduled Open Door Forum
If you thought you missed Medicare’s Jan. 11 Home Health, Hospice and DME Open Doo... Read more
Hospice News:
Watch Out For This HIPAA-Based Marketing Scam
Don’t let your zeal for HIPAA compliance put you at risk. A cybersecurity firm tar... Read more
Hospice News:
Don't Let One Provider's $25K HIPAA Fine Become Your Fate
HIPAA penalties don’t just come from the federal government. For example: New Yo... Read more
Medicare Issues New Model Hospice Election Statement
New form addresses OIG concerns. You’ll need to get up to speed on a new model f... Read more
Consider These 3 Options Carefully To Address New Model Election Statement
What’s your next move? If you can’t decide exactly what to do about Medica... Read more
Assess These 3 Compliance Hot Spots Highlighted By The OIG
Fraud and abuse scrutiny to get even heavier in 2017. The HHS Office of Inspector Gene... Read more
Alert: New Year, New Medicare Data
Plus: Have you checked your directory information yet? You can kick off 2017 with new ... Read more
HHS Secretary Nominee Has Promising Track Record With Home-Based Care
Experts anticipate these possible changes under new administration. Whether the Trump ... Read more
Labor Law:
Keep Your Eye On Overtime Rule Lawsuit
DOL files notice of appeal. Your labor law compliance status — and risk of emplo... Read more
Hospice News:
VITAS Settles Whistleblower Lawsuit For $200K
For-profit chain denies wrongdoing. When one of your referral sources gets locked up f... Read more
Hospice News:
Hospices Should Have One Less Billing Headache
You should no longer see claims held up in error with code U5112, HHH Medicare Administr... Read more