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HOSPICE CAP CALCULATIONS LETTERS AND ADMINISTRATIVE APPEALS

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Tuesday, 28 April 2009
The Centers for Medicare and Medicaid Services (CMS) recently released MLN Matters article MM6400 titled, “Hospice Cap Calculations Letters and Administrative Appeals.” Medicare contractors, Regional Home Health Intermediaries (RHHIs) and Medicare Administrative Contractors (MACs), are required to send each hospice provider a letter which serves as a determination of program reimbursement, regardless of whether or not they have exceeded a cap.  The caps in question can be either on payments for inpatient days or the aggregate cap on total payments. Read full article.
 

MEDPAC MAKES ANNUAL RECOMMENDATIONS TO CONGRESS

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Tuesday, 10 March 2009

Each March, the Medicare Payment Advisory Commission (MedPAC) reports to Congress on its review and recommendations for the Medicare fee-for-service and Medicare Advantage programs.  As in years past, MedPAC’s primary concern is the rapid growth in Medicare spending and slowing that growth in order to sustain the program as long as possible. Read full article.

 

NEW SEVEN YEAR RETENTION REQUIREMENT FOR REFERRING PHYSICIAN DOCUMENTATION

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Thursday, 12 February 2009
The Centers for Medicare and Medicaid Services (CMS) has established a new record retention requirement that is applicable to home health agencies and hospices.  This requirement can be found in Regulation Section 424.516(f), and became effective January 1, 2009. Read full article.
 

OIG 2009 WORK PLAN RELEASED FOR HOSPICES

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Thursday, 30 October 2008


On October 1, 2008, the Office of Inspector General (OIG) released its yearly Work Plan of initiatives for federal fiscal year 2009, which began on October 1, 2008.  Areas of particular interest to Hospices are:
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HOSPICE MEDICARE RATES FOR FY 2009 FINAL CORRECTION

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Wednesday, 29 October 2008


This correction, with updated payment rates, is being issued to correct an error in our previous calculations.  The attached rates are for the period October 1, 2008 through September 30, 2009.

On August 8, 2008, the Centers for Medicare & Medicaid Services (CMS) issued the Hospice Wage Index for Fiscal Year 2009 Final Rule.  This final rule provides for a payment increase consisting of a 3.6% market basket increase less a 1.1% decrease in the Budget Neutrality Adjustment Factor (BNAF).  The 3.6% increase is applied to the national base rates from CMS Transmittal 1570 dated August 1, 2008, and the 1.1% BNAF reduction is applied to the geographically adjusted wage indices as indicated in the Federal Register dated August 8, 2008.
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