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FY 2023 HOSPICE PAYMENT RATES – QUESTIONS ANSWERED

 Volume 22.15 FY 2023 hospice payment rates, effective October 1, 2023, have been set.  Routine home care rates are as follows, before any wage index adjustment based on the location of the patient: FY 2023 Hospice RHC Payment Rates  Code       Description           ...

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2022 HOSPICE FINANCIAL ACADEMY HIGHLIGHTS

Volume 22.15 We are very excited as we finalize our plans for the upcoming 2022 Hospice Financial Management Academy to be held on September 19-20, 2022.  We are thrilled to be back at the Hotel Monteleone in New Orleans and look forward to seeing many clients and...

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CMS RELEASES FINAL HOSPICE RATE UPDATE

Volume 22.13 The U.S. Centers for Medicare & Medicaid Services (“CMS”) has released the final rule updating the Medicare hospice payment rates and aggregate CAP amount for FY 2023, which begins on October 1, 2022. The FY 2023 hospice payment update percentage is...

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Hospice Alert 22.10

IRS INCREASES ALLOWABLE MILEAGE REIMBURSEMENT Effective July 1, 2022, the standard mileage rate for business travel has been increased to 62.5 cents per mile, an increase of 4 cents from the current allowable reimbursement rate. This increase, mid-year, is in...

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Hospice Alert 22.09

 Volume 22.09 CLARITY IN CAP LIABILITY PROVISIONS OF PURCHASE AGREEMENTS  As more hospices exceed hospice aggregate payment limitations (“CAP”) and hospice acquisitions continue at a rapid pace, we are constantly becoming involved in disputes between the Buyer and the...

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HOSPICE CAP LIABILITY AND CLAIM DENIALS

Volume 22.08 As hospices become subjected to claims denials, whether such denials are the result of a UPIC or not, the hospice may be entitled to a refund of previously paid CAP liabilities.  We reported on this in 2021; however, The Health Group, LLC ("THG") recently...

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CMS RELEASES PROPOSED 2023 PAYMENT UPDATE

 Volume 22.07 Yesterday, March 30, 2022, CMS issued the proposed rule that would update Medicare hospice payment rates and the aggregate payment limitation (“CAP”) effective October 1, 2022.  2022-07030.pdf (federalregister.gov). The proposed rate increase in Medicare...

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PRESIDENT SIGNS OMNIBUS SPENDING BILL

Volume 22.06 Last week President Biden signed into law a $1.5 trillion spending package, referred to as an “Omnibus Spending Bill”.  The legislation will fund the government through September 2022.  The Bill also provides significant financial assistance to Ukraine....

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Hospice Alert 22.04

 Volume 22.04 TECHNICAL CORRECTION Our last Hospice Alert (Volume 22.03) indicated that CMS revised the Hospice Cost & Data Report on September 25, 2022. The actual date of the revision was February 25, 2022, and is available here. HOSPICE CAP OBSERVATIONS...

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CMS MAKES MINOR CHANGES TO HOSPICE COST REPORT

 Volume 22.03 On September 25, 2022, CMS revised the Hospice Cost & Data Report to add a new non-reimbursable cost center to accumulate costs associated with suicide accomplished with aid of a physician in those states that allow assisted suicide. Federal funds...

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SELF-DETERMINED HOSPICE CAP OVERPAYMENTS

 Volume 22.02 According to MedPAC, almost 20% of all hospice providers are now exceeding the Medicare aggregate payment limitation (“CAP”).  Many hospices will have a CAP liability when they file their self-determined CAP liability report on or before February 28,...

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MEDPAC AND HOSPICE CAP REDUCTION RECOMMENDATIONS

Volume 22.01 The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 (P.L. 105-33) to advise the U.S. Congress on issues affecting the Medicare program. In addition to advising the...

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READY FOR CAP REPORTING?

Volume 21.17 Medicare- certified hospices are required to self-report the calculated aggregate payment limitation (“CAP”) no earlier than three (3) months after, and no later than five (5) months after the end of the hospice CAP Year.  The 2021 CAP Year runs from...

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OIG REPORTS ON PALMETTO GBA, LLC CAP MANAGEMENT

Volume 21.16 The U.S. Department of Health & Human Services (“DHHS”) Office of Inspector General (“OIG”) issued a Report in July 2021 regarding the CAP management process of Palmetto GBA, LLC (“Palmetto”).  Palmetto was selected from the Medicare Administrative...

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2021 HOSPICE FINANCIAL MANAGEMENT ACADEMY

 Volume 21.13 We are very excited to be sponsoring our Hospice Financial Management Academy live again.  The 2021 program will be held at the Paris Hotel and Casino in Las Vegas on September 13-14, 2021.  The response to this program has been tremendous. Based on...

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2022 HOSPICE PAYMENT RULE RELEASED

 Volume 21.12 CMS has issued the final rule, “Medicare Program; FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements”. This final rule: Updates the hospice wage...

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COULD YOUR HOSPICE OVERPAY A CAP LIABILITY?

Volume 21.09 Recently, we have identified another hospice that has overpaid its CAP liability.  This happens when a hospice has claims denied and is also subject to CAP overpayments. When a claim is retroactively denied for a completed CAP Year, the denied claims...

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ADVANCE CONFERENCE PROGRAM AVAILABLE

Volume 21.07 The Advance Conference Program and registration information for our upcoming Hospice Financial Management Academy is now available. The program will be held at the Paris Las Vegas Hotel & Casino on September 13-14, 2021.  Early registration discounts...

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HOSPICE NEWS REPORTS ON PRESENTATION BY RYAN LINDSAY

Volume 21.04 This week Ryan Lindsay, CPA, Director at The Health Group, LLC, spoke at the Annual Meeting of the National Hospice & Palliative Care Organization (“NHPCO”).  His presentation, “Amazon Will Change How Hospices Do Business”, was reported on by Hospice...

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MORE HOSPICES EXCEED HOSPICE CAP IN 2020 CAP YEAR

Volume 21.02 After preparing substantial numbers of self-determined CAP Report filings for the 2020 CAP Year and CAP liability assessment reports for hospices across the country, it is increasingly obvious to us that greater numbers of hospices are exceeding hospice...

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MEDICARE PROGRAM REVALIDATIONS

Volume 21.01 We continually receive questions regarding Medicare enrollment revalidations.  CMS has temporarily ceased revalidation efforts for all Medicare providers or suppliers.  During the public health emergency, CMS will not issue any new revalidation notices,...

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MEDPAC CONTINUES TO PURSUE 20% CAP REDUCTION

Volume 20.16 At the recent meeting of the Medicare Payment Advisory Commission (“MedPAC”), the matter of wage adjusting the Medicare Aggregate Payment Limitation (“CAP”) and reducing the CAP by an arbitrary 20% was again discussed as MedPAC moves toward making its...

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CMS UPDATES MEDICAID HOSPICE PAYMENT RATES

Volume 20.15 On September 14, 2020, CMS released Medicaid payment rates for FY 2021 (beginning October 1, 2020).  The Medicaid hospice payment rates are calculated based on the annual hospice rates established under Medicare.  These rates are authorized by section...

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2020-2021 MEDICARE HOSPICE PAYMENT RATES FINALIZED

Volume 20.14 On July 31, 2020, the U.S. Centers for Medicare & Medicaid Services (“CMS”) released the final FY2021 hospice payment rule (“Rule”).  The national hospice payment rates, subject to geographical application, and the hospice CAP will increase by 2.4%...

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THE HOSPICE COST REPORT AND COVID-19 PHE EXPENSES

Volume 20.13 The Hospice Cost & Data Report (“Cost Report”) was substantially modified in 2014 to facilitate the accumulation of hospice costs by level of care (“LOC”), as well as capture other information, which can be used in establishing Medicare reimbursement...

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REPORTING TELEHEALTH COSTS

Volume 20.09 To better address the needs of patients during the COVID-19 PHE, hospices can provide telehealth services to patients receiving routine home care if feasible and appropriate.  Additionally, face-to-face encounters can now be conducted by telehealth....

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PROPOSED HOSPICE PAYMENT RULE RELEASED

Volume 20.08 The U.S. Centers for Medicare & Medicaid Services (“CMS”) has released the proposed 2021 Hospice Wage Index and Payment Rate Update, which is scheduled for publication in the Federal Register on April 15, 2020. This proposed rule would update the...

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