Hospice Update: Claim Adjustments for RHC Payment Errors Suspended
September 29, 2016 04:39 PM
Since implementation of the two-tiered payment system for hospice routing home care (RHC) on January 1, 2016, a number of issues have arisen relative to the proper processing of hospice claims, and CMS has taken steps to correct these issues. CMS announced in the August 18, 2016, MLN Connects Provider E-Newsthat a correction related to two such systems issues -- under which RHC days were being miscounted on hospice claims -- was implemented on July 25, and that the Medicare Administrative Contractors (MACs) would be adjusting hospice claims to correct payment. No provider action was necessary.
It is NAHC’s understanding that despite the July correction, payments for these claims are not processing correctly. As a result, the MACs are suspending adjustments to correct these claims until a solution is implemented. CMS has issued notice of this in the September 29, 2016 MLN Connects Provider E-News.
NAHC will continue to follow this issue and keep you informed of developments.