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HCL News - Important Information Regarding Hospice Election Statement, Hospice Audit Resumptions, and Home Health RCD

HCL News - Important Information Regarding Hospice Election Statement, Hospice Audit Resumptions, and Home Health RCD

Hospice Election Statement Addendum
The Centers for Medicare & Medicaid Services (CMS) has provided links to the Model Hospice Election Statement – Modified July 2020 and the Model Hospice Election Statement Addendum – Modified July 2020 to further assist with understanding the content requirements for the hospice election statement and addendum, which are effective October 1, 2020. These requirements reflect the changes finalized in the FY 2020 Hospice Wage Index and Payment Rate Update final rule (84 FR 38520), and were implemented in order to increase coverage transparency for beneficiaries electing the Medicare hospice benefit. HealthCare ConsultLink (HCL) is working diligently to provide the new addendum in the online policy manuals, and will notify current subscribers of this update once it is posted to the manuals.

Hospice Audit Resumptions
To protect the Medicare Trust Fund against inappropriate payments, the Medicare Administrative Contractors (MACs) are resuming fee-for-service medical review activities. Beginning August 17th, the MACs are resuming with post-payment reviews of items / services provided before March 1, 2020. The Targeted Probe and Educate (TPE) program will resume at a later date to be announced. The MACs will continue to offer detailed review decisions and education as appropriate.

Home Health Important Reminder – Per Palmetto, CMS will restart the RCD following the pause for COVID-19
The end date for the Review Choice Demonstration (RCD) Cycle 1 for Texas providers has been updated due to the COVID-19 pause. Home health claims in all demonstration states with billing periods on or after August 31, 2020, will be subject to review under the requirements of the choice selected. In Texas, Cycle 1 began on March 2, 2020, and was paused after one month. The remaining five months of the Cycle will begin on August 31, 2020, and end on January 31, 2021. For providers who continued to submit pre-claim review (PCR) requests during the pause, those decisions will be included in their Cycle 1 affirmation rate. Palmetto has published the updated cycles for the providers in Texas.

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