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:: NAHC Report
NAHC Report: Issue# 2192, 5/9/2013
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Hospice Claims and Use of Debility, Adult Failure to Thrive, and Dementia Diagnoses
NAHC Working to Improve Falls Prevention with Coalition
For Your Information: Education Sessions Announced for NAHC's 2013 Annual Meeting & Exposition
NAHC/Home Care & Hospice Events
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Hospice Claims and Use of Debility, Adult Failure to Thrive, and Dementia Diagnoses
CMS expects that hospices not use ‘debility’ and ‘adult failure to thrive’ as the primary diagnosis on hospice claims effective immediately.

In the April 30, 2013 edition of NAHC Report, a summary was provided for the FY2014 Hospice Wage Index proposal that included some details of the portion of the proposed rule related to multiple diagnoses on hospice claims and specifically hospices’ use of ‘debility’, ‘adult failure to thrive’, and dementia as the principal diagnosis.

CMS indicated that hospices should not use these diagnoses as the principal diagnosis, and that in the future they will return to provider (RTP) claims with ‘debility’ or ‘adult failure to thrive’ as the principal diagnoses. In the CMS Open Door Forum (ODF) on May 8, 2013 CMS indicated that instruction to contractors for RTPing these claims would be coming out soon. No particular date was given but it is clear that CMS has warned providers about the need to RTP claims and that providers should not be coding these diagnoses as the principal diagnosis.

NAHC strongly recommends that all hospices review each case where ‘debility’ or ‘adult failure to thrive’ is listed as the principal diagnosis.

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Education Sessions Announced for NAHC's 2013 Annual Meeting & Exposition

Visit the Annual Meeting section of NAHC’s Website to view the exciting collection of Education Sessions being offered at this year’s Annual Meeting and Exposition.

With the future of Medicare at stake, now more than ever, members of NAHC must join together and connect with legislators face-to-face to share the stories that only hospice and home care providers can. Washington, DC is the center of activity and the best place for NAHC to make an impact.

Register today to attend NAHC’s Annual Meeting and Exposition.

Visit the CARING Store online for the latest Resources

NAHC Working to Improve Falls Prevention with Coalition

Falls remain the leading cause of injury death for older Americans, threatening seniors’ safety and independence daily, and generating enormous economic and personal costs. Some statistics from the CDC on the breadth and depth of the costs that falls costs in terms of both medical costs and to the healthcare system include:

  • In 2009, more than 20,000 older Americans died from injuries related to unintentional falls.
  • In 2010, over 2.3 million older Americans were treated in emergency departments for nonfatal injuries from falls and more than 650,000 were hospitalized. CDC reports the death rate from falls among older adults has increased by 42% from 2000 to 2006.
  • The total cost of fall injuries for older Americans was estimated to be $28.2 billion (in 2010 dollars). By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion.

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