Jurisdiction M (JM) Home Health and Hospice (HHH) POE Advisory Group (POE-AG) Group (POE-AG) Minutes: January 18, 2024

Published 02/05/2024

Facilitators: Dan George, Marlene Frierson, Charles Canaan and Elizabeth Brogdon

Attendees: 22

Welcome

Our Goals

  • Establishing and maintaining strong relationships with Palmetto GBA and our provider community 
  • Meeting with Palmetto GBA and the provider community on a quarterly basis 
  • Providing the communication tools to facilitate thorough and prompt transfer of information 
  • Coordinating issues within the provider community to adequately reflect the concerns of the majority

POE-AG Goals and Purpose — HHH POE-AG Charter.

Old Business: Prior POE-AG Suggestions/Recommendations 

  • Could a one page face-to-face checklist be created by Palmetto GBA just for physicians/practitioners?
    • Home Health Face-to-Face Checklist (PDF) Palmetto GBA created this checklist, and it was approved by the association, who wanted all the information included and added to it. Would the group like to review and determine what can be removed.?

New Business: POE-AG Training Suggestions and Education Recommendations
Participating members have the opportunity to benefit the provider community by helping to guide Palmetto GBA educational strategy for the upcoming year.

Information to Share

Home Health

Hospice

  • Hospice Benefit Policy Manual Updates Related to the Addition of Marriage and Family Therapists (MFTs) or Mental Health Counselors (MHCs) to the Hospice Interdisciplinary Team. The purpose of this Change Request (CR) is to manualize changes to the hospice interdisciplinary group (IDG) to include Marriage and Family Therapists (MFTs) or Mental Health Counselors (MHCs). In the CY 2024 Physician Fee Schedule Final Rule, CMS finalized modifications to the hospice conditions of participation to permit MFTs or MHCs to serve as members of the hospice IDG (§§ 418.56 and 418.114).
  • 2023 SDHC Report — Form and Due Date. The 2023 Self-Determined Hospice Cap (SDHC) Report covers the 12-month period October 1, 2022, through September 30, 2023. Submission is required by February 29, 2024. If not received timely, a past due letter will be issued and payments will be suspended.
  • Provider Statistical and Reimbursement System: Order Detail Report. A Detail Report will list each claim processed in the requested period (and can be very lengthy). This report is useful if seeking information on a specific claim or a specific patient. However, the Detail Report is not useful if summarized information is needed. Typically, for preparing reports, the Summary Report offers the needed information.
  • Hospice Caps Job Aid — This updated job aid explains the two caps that affect Medicare payments under the hospice benefit.
  • Hospice Caps — To ensure that the cost of hospice care does not exceed the cost of conventional care, CMS established two annual caps (or limits) on hospice payments.

Coming Soon

  • Final Rule Education
    • Hospice Certifying Physician
      • If the hospice bills for physician services, that physician/practitioner will need a Medicare enrollment that entitles them to bill Medicare directly. A hospice cannot bill services for a physician/practitioner that does not have the right to bill Medicare themselves. 
        • CMS-855I (PDF) for Physicians and Nonphysician Practitioners
          • Complete this application if you are an individual practitioner or eligible professional who plans to bill or have another provider type bill Medicare for medically necessary services you provide.
        • CMS-855O (PDF) for Ordering and Certifying Physicians and Nonphysician Practitioners
          • Complete this application if you are an individual practitioner or eligible professional and enrolling sole purpose of ordering or certifying items and/or services to beneficiaries in the Medicare program.
        • Opt-Out Affidavit for Eligible Physicians/Practitioners

RCD NewsJurisdiction M HHH - Home Health Review Choice Demonstration (HH RCD) Monthly Provider Webinar - February 7, 2024

Upcoming Education Events

eServices

  • Non-Cancer Length of Stay Rates April 1 to September 30, 2023. This electronic Comparative Billing Report (eCBR) is now available in eServices and focuses on Non-Cancer Length of Stay (NCLOS) rates from April 1 to September 30, 2023.
  • Why am I missing eligibility information? You may not be seeing information in the eligibility tabs because you are not entering a date range on the inquiry screen. To make sure you see all the information, enter a date range in the inquiry screen.
  • eServices Appeals Feature  — Palmetto GBA has enhanced eServices with new appeals features. Part A and home health and hospice providers actively using eServices to the Claims Inquiry tab can get an up-to-date appeals status, view, and download decision letters and more.

Open Discussion 

Question: The electronic Comparative Billing Report (eCBR) for Non-Cancer Length of Stay (NCLOS) rates from April 1 to September 30, 2023, are not available in eServices. Does Palmetto GBA know when they will be available?

Answer: They are all available on February 1, 2024. For your personalized NCLOS eCBR results Logon to eServices.

Question: CMS developed and posted a questions and answers document about the recent hospice benefit policy manual updates related to the addition of marriage and family therapists or mental health counselors to the hospice interdisciplinary team. Could Palmetto GBA link those questions and answers to the MAC website?

Answer: Yes. In response to this question, Palmetto GBA published the article Jurisdiction M HHH - Hospice Benefit Policy Manual Updates Related to the Addition of Marriage and Family Therapists or Mental Health Counselors to the Hospice Interdisciplinary Team and linked the CMS questions and answers document in the article. 

Next Meeting: April 11, 2024
 


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