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Volume 22.12

Hospices can sign-up to participate in the CMS Part D and Hospice Election Pilot Program through July 31, 2022.  The primary focus of the Pilot Program is the acceleration of communications and notifications between the Hospice, Medicare Part D Plans, and CMS to better coordinate responsibility and payments relating to prescription drugs once a patient has elected hospice care.  CMS reported that Part D spending in 2019, while patients were on hospice care, was $498,913,448.

Recently the National Council for Prescription Drug Programs (“NCPDP”), in cooperation with CMS, RelayHealth/McKesson, Elixir Solutions, MatrixCare, and NHPCO, provided a one-hour webinar describing the Pilot Program.  Regardless of the level of your interest, we encourage you to take the time for the video.

The OIG has issued reports relating to Medicare overpayments for drugs when the patient has elected hospice care.  Two of these reports are available here and here.   In response to these and other reports, CMS is pursuing the development of programs to eliminate Part D billing on behalf of Medicare patients when the hospice has accepted responsibility for the payment of these drugs as part of the hospice benefit.

Requirements for hospices to participate in the pilot include:

  • Confirm CMR vendor capability to generate electronic NOE in electronic HIPAA 8371 format and
  • Submit the following information along with a Business Associate Agreement in the format provided at https://medifacd.mckesson.com/Hospice/Hospice-Providers/:
    • Agency NPI
    • Organization Name
    • Primary Contact
    • Phone Number
    • Email Address
    • Method of NOE Submission (Clearinghouse or Direct).

This information is to be submitted to hospicesupport@relayhealth.com.  Additional inquiries can be directed to aclark@NCPDP.org.  We hope to have early reports on the progress of the Pilot Program at our upcoming 2022 Hospice Financial Management Academy.


Early registration for the 2022 Hospice Financial Management Academy will be ending July 15, 2022.  We are very excited about the interest in this program, which is scheduled for September 19-20, 2022, at one of our favorite properties, the Hotel Monteleone, New Orleans.  The two-day program is set; however, additional topical coverage will continually be added up-to the program date as events transpire.  Special room rates have been secured with the hotel ($189/night).  Space is limited to enhance the interactive nature of the program.  Registration, hotel, and other information is available here.  We hope to see you in New Orleans!