Monitoring Medicare Enrollment
The Medicare Enrollment information on file may be the most important information to a healthcare provider. While all healthcare providers must re-validate 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.
New Hospice Cost Report
The U.S. Centers for Medicare and Medicaid Services (“CMS”) released the final “new” Hospice Cost & Data Report (CMS Form 1984-14) at the end of 2014. Hospice cost reports for cost reporting years beginning on or after October 1, 2014 are to be submitted using the new forms. Most hospices will be filing the new forms over the next few months.
The new Hospice Cost & Data Report represents a substantial modification to the existing cost report and required 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, and develop processes for continuous accumulation of the required cost and statistical information.
The Health Group, LLC has already submitted several reports using the new forms. Do not hesitate to contact us if we can provide assistance to you including preparation of the new report
Hospice Cap Reports
Hospice providers will again be submitting their self-determined CAP Report on or before March 31, 2016. This submission will be for the 2015 CAP Year which ended October 31, 2015.
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 the submission for the 2015 CAP Year will require sequestration to be included. The self-determined CAP Report forms should be updated soon. Recently the Medicare Administrative Contractors have been updated prior year CAP computations as we expected.
It is imperative that hospices 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.