The Health Group, LLC
The Health Group, LLC is available to meet the cost reporting, corporate compliance, Medicare enrollment and state licensure, strategic planning, accounting and financial reporting assistance, merger/acquisition and general healthcare financial consulting needs of healthcare providers. These services are provided by professionals of The Health Group, LLC and our network of professional resources across the country.
Our professionals have extensive experience working with hospitals, nursing homes, physician practices, clinics, hospice, home health, HME and other healthcare providers. We focus on providing services that assist our clients to accomplish their respective objectives.
Our clients are located across the country. Whether your organization is proprietary, tax-exempt, or governmental; free-standing or provider-based, we have the resources to meet your healthcare financial needs.
Additionally, we provide extensive educational information and updates to our clients, our referral sources, and others in support of the healthcare industry including national and state healthcare associations. We look forward to hearing from you or meeting with you to discuss how The Health Group, LLC can be a valuable resource in your healthcare endeavors.
The U.S. Centers for Medicare and Medicaid Services (“CMS”) has released the final “new” Hospice Cost & Data Report (CMS Form 1984-14). Hospice cost reports for cost reporting years beginning on or after October 1, 2014 are to be submitted using the new forms. The new Hospice Cost & Data Report represents a substantial modification to the existing cost report and requires all hospices to modify their existing chart of accounts, develop methodologies for accumulating the newly required financial information, prepare for the statistics that will be required for reclassification and allocation of costs, develop processes for continuous accumulation of the required cost and statistical information, prepare for increased cost report edits, and possibly request alternative statistics as well as modifying the order of cost allocation. CMS has readily admitted the revised cost report is designed to secure information necessary for rate setting by LOC.
Our upcoming program, September 24-25,2015, will provide attendees with an understanding of the new report, including assessing their ability to complete this report or enable their consultants to complete this report. Additionally, the program will provide significant attention to CAP reporting, understanding CAP liabilities, and managing these liabilities. Other financial and compliance-related issues are on the preliminary agenda. As always, programs of The Health Group, LLC are the most comprehensive available on the subject matter. The program will be held at New York-New York Hotel & Casino, Las Vegas, Nevada. Contact us to make certain you receive registration information as soon as available. Space is limited for this program.
The Medicare Enrollment information on file may be the most important information to a healthcare provider. While all healthcare providers must revalidate their information on file when requested to do so, a failure to modify information can result in the loss of billing privileges by the healthcare provider.
Changes in information on file with the Medicare program must be updated within ninety (90) days of the change. This includes practice location changes, additions and deletions to practice locations, direct and indirect ownership (whether individuals or organizations)changes, changes in Board members of tax-exempt providers, accreditation and licensure changes, and more. Providers need to be keenly aware of that information on file with the Medicare program and make timely changes to this information.
The Medicare Administrative Contractors (“MACs”) have been extremely lenient regarding the timeliness of change submissions; however, the risk is enormous. The denial of billing privileges could represent a financial challenge that would be difficult to overcome. When addressing corporate compliance all providers should ensure that Medicare enrollment information and updating that information is included.
Effective for the 2014 CAP Year (November 1, 2013 through October 31, 2014) hospices are now required to file their own CAP Report with their respective Medicare Administrative Contractor (“MAC”). Additionally, the MACs have initiated release of 2013 CAP Notices which incorporate sequestration into the determination of any CAP liability.
The CAP Report submitted by hospices for the 2014 CAP Year did not incorporate sequestration into the determination of any liability. It is expected that beginning in the fall of 2015, the MACs will update the 2014 CAP computation, incorporate sequestration into the computations, and, where necessary, send notices to hospices requesting repayment of any liability or additional liability beyond what was determined at the time of the self-reporting (on or before March 31, 2015).
Many hospices found themselves with a 2014 CAP Year liability when they filed their report in March 2015 and then immediately received the Notice of CAP liability for the 2013 CAP Year. It is imperative that hospices begin to monitor CAP liabilities throughout the year, recognizing that CAP liabilities change daily and that the MAC can recalculate CAP liabilities as frequently as they desire for three (3) years from the date of the original Notice of CAP liability.