Hospice providers within regions administered by NGS are reporting that NGS is presently finalizing and serving out final 2019 hospice cap repayment demands. This action, which tacks on sequestration (funds never received) to...more
On August 6, 2019, CMS finalized its 2020 hospice rule, including adopting, without substantial modification, two controversial and material changes to the hospice benefit:
Rebasing payment rates to shift about $500...more
8/12/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Healthcare ,
Home Health Care ,
Hospice ,
Medicare ,
MedPAC ,
OIG ,
Payment Systems ,
Rulemaking Process
With the FY 2020 proposed hospice rule, CMS proposes two material changes for hospice providers:
• CMS proposes to shift approximately $500 million of hospice funding (2.7% of payments) from routine care to enhanced care...more
5/3/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Conditions of Payment ,
Federal Funding ,
Health Care Providers ,
Home Health Agencies ,
Hospice ,
Medical Reimbursement ,
Medicare ,
Patients ,
Proposed Rules ,
Provider Payments ,
Terminal Illness Treatments
In its FY 2020 proposed hospice update, CMS proposes two changes of significant interest to providers:
• Shifting $500 million of reimbursement from routine to enhanced care levels; and
• Requiring providers to notify...more
On Thursday, February 28, 2019, two years after hearing arguments in lead group cases, the Provider Reimbursement Review Board affirmed CMS’ approach to counting sequestered funds as part of provider revenue for hospice cap...more
This year CMS is rolling out two new programs aimed, finally, at helping to settle certain types of pending provider reimbursement appeals. The programs are the Low Volume Appeals Initiative and Settlement Conference...more
On April 30, 2015, CMS released its FY 2015 Hospice Wage Index, including long anticipated payment reform and some changes to the hospice cap calculation. Comments are due by June 29. Here is an initial summary and...more
CMS seeks to recover from providers $125 million in alleged overpayments for services to beneficiaries who are belatedly identified as ineligible (incarcerated/unlawfully present). In this post, Sheppard Mullin examines the...more