(304) 241-1261 contact@healthgroup.com

Volume 21.14

Yesterday the National Association for Home Care & Hospice announced the cancellation of the upcoming 2021 Home Care and Hospice Conference and Expo, which was scheduled for October 3-5, 2021, in New Orleans.

“This was a very difficult decision to make and everyone at NAHC is very disappointed that it became necessary to cancel the conference,” said NAHC President William A. Dombi. “However, the safety of our guests is of paramount importance and the devastation caused by Hurricane Ida made it impossible for us to assure our attendees they would enjoy a safe and productive conference.”

The Health Group, LLC was scheduled to exhibit at the meeting.  We look forward to planning for the 2022 event, which is scheduled for St. Louis.

HOSPICE FINANCIAL MANAGEMENT ACADEMY HAPPENS NEXT WEEK

The Hospice Financial Management Academy, sponsored by The Health Group, LLC, begins Monday, September 13, 2021, at the Paris Hotel & Casino in Las Vegas.  We are very excited to be part of the live, in person education and networking event.  The two-day program, which accepts limited attendees, only has three (3) spots remaining for last minute registrants.  If interested, please register by Thursday.  On-site registrations are not accepted.

The program is diverse and includes discussion on the following topics:

  • Hospice financial and administrative oversight
  • Provider relief funds – status and reporting
  • Cost reports and changes to hospice payment rates
  • Transform your organization with use of business intelligence to be the provider of choice for Medicare Advantage!
  • Hospice CAP update; managing CAP
  • Addressing proposed and anticipated changes
  • Enrollment changes finalized
  • Understanding the Medicare Advantage carve in – how does the model work?
  • Financial management panel – open discussion

Details are available here.  Attendees will be able to download program materials later this week.  Instructions will be emailed to all attendees.

CMS PROPOSES TO EXPAND POTENTIAL TO REVOKE A PROVIDER’S ENROLLMENT

Under § 424.535(a)(8)(ii), CMS may revoke a provider’s or supplier’s enrollment if CMS determines that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements.  According to CMS, due to recently encountered situations, revisions to the current rule are necessary to increase flexibility to address periods of abusive billing, irrespective of the duration of the abusive billing.

Under the proposed rule, Federal Register :: Medicare Program; CY 2022 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-Payment Medical Review Requirements, instead of looking at claim denials over the period of Medicare enrollment, CMS could use a much smaller period for the determination of a risk of improper payments.  The following factors would be applied for purposes of potential Medicare enrollment revocation:

  • The percentage of submitted claims that were denied during the period under consideration.
  • Whether the provider or supplier has any history of final adverse actions and the nature of any such actions.
  • The type of billing non-compliance and the specific facts surrounding said non-compliance (to the extent this can be determined).
  • Any other information regarding the provider or supplier’s specific circumstances that CMS deems relevant to its determination.