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NAHC Report: Issue# 2299, 10/22/2013
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Providing Vaccines to Hospice Beneficiaries
Home Care Medicaid Fraud Developments in Florida, Maryland, and Illinois
For Your Information: NAHC Will Host Free October 23 Teleconference on Rebasing
NAHC/Home Care & Hospice Events
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Providing Vaccines to Hospice Beneficiaries

In a Change Request (CR 8098) issued May 3, 2013, the Centers for Medicare & Medicaid Services (CMS) indicated that, effective October 1, 2013 - for implementation on October 7, 2013 - Medicare systems will prevent non-hospice providers from providing vaccines to hospice patients. While a hospice may provide influenza, pneumococcal, and hepatitis B vaccines to hospice-enrolled beneficiaries who request them, and may bill the Part B Carrier for both the vaccine and an administration fee, any other provider will be denied reimbursement.

Medicare systems previously did not have the ability to differentiate between claims for the vaccines submitted by hospices and other providers/suppliers. CMS has now established an edit to the Common Working File (CWF) that allows the Medicare Administrative Contractors (MACs) to reject claims submitted by non-hospice providers for vaccines provided to hospice beneficiaries. Issuance of CR 8098 has raised a number of questions; they include questions on how a hospice provider may become a Part B supplier in order to bill for vaccines. Following is information that has been gathered to help address outstanding questions.

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NAHC Will Host Free October 23 Teleconference on Rebasing

What: A free teleconference. The National Association for Homecare & Hospice (NAHC) will host a free teleconference to highlight issues of critical importance to the home care and hospice community.

When: This Wednesday, October 23rd, from 1:00 p.m. to 2:00 p.m. EST. The number to call in US/CAN Toll free is 1-800-216-6327 and the code is 585731.

What issues will be discussed: a) Where things stand with “rebasing” the Medicare home health benefit; b) What will happen when we reach the new debt ceiling on February 7, 2014; c) Will there be another crusade to repeal or delay the Affordable Care Act; d) Where are things going with the Conference Committee that must reach an agreement on possible Medicare cuts and tax increases byDecember 13, 2013; e) What’s new at the NAHC Annual Meeting & Exposition in Washington, D.C. on October 31 – November 3, 2013; and, f) Who will win the 2014 elections.

Who is conducting the seminar: Val J. Halamandaris, President of NAHC; Jeff Kincheloe, Vice President for Government Affairs; Bill Dombi, Vice President for Law; Richard Brennan, Vice President for Technology Policy and Government Affairs; and Theresa Forster, Vice President for Hospice Policy and Programs.

Who may participate: NAHC members will receive priority, but the conference is open to all. Please send an email to to reserve your place on the call. The first 300 people will be guaranteed a place on the call.

Will questions be allowed: Yes. Your questions will be received 24-hours in advance of the broadcast and will close at 12:45 pm EST on the date of the broadcast. Send questions to Barbara D. Woolley, Director of Communications at

Will the teleconference be recorded: Yes. The teleconference will be recorded. The highlights will appear in NAHC Report, NAHC’s daily electronic newsletter and summarized in CARING, its monthly magazine.

Visit the CARING Store online for the latest Resources

Home Care Medicaid Fraud Developments in Florida, Maryland, and Illinois

The National Council on Medicaid Home Care – a NAHC affiliate - reports on recent developments in home care Medicaid fraud and abuse, including: 1) alleged overbilling of unauthorized services in Florida; 2) convicted fraud of a caregiver in Maryland; and 3) convicted beneficiary fraud in Illinois.


As reported by Local 10 News in Florida, on October 9, a Florida state audit found that the home care organization of the vice mayor of Broward County, Barbara Sharief, billed for unauthorized Medicaid services.  The audit alleges that South Florida Pediatric Homecare (SFPH) overbilled the program $220,000, which the state is asking for back, as well as $44,000 in fines.  This audit is currently being litigated. 

Sharief had agreed to settle a previous audit for about $540,000, which included approximately $50,000 in fines. In this audit, the state alleged that SFPH overcharged for services lacking documentation, charging registered nursing rates when licensed practical nurses administered the services, and billed services unauthorized by physicians.  

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