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:: NAHC Report
NAHC Report: Issue# 2306, 10/31/2013
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Palmetto to Conduct Hospice Specific Prepay Probe Review and CGS Expands Widespread Length of Stay Edits
Iowa’s Program Integrity Initiative Yields $86 Million in Savings
For Your Information: The Annual Meeting & Exposition is Underway.
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Palmetto to Conduct Hospice Specific Prepay Probe Review and CGS Expands Widespread Length of Stay Edits

On October 30, 2013 two Medicare Administrative Contractors (MACs) announced actions impacting hospices. Palmetto GBA posted a notice that it will perform a service-specific prepay probe review on hospice claims with non-cancer diagnoses, billed with place of service Skilled Nursing Facility, HCPCS code Q5004.

The claims timeframe was not specified, but Palmetto GBA has identified top providers with a large number of beneficiaries receiving hospice services in Skilled Nursing Facilities. A service-specific probe will be initiated in J11 to look at beneficiaries with non-cancer diagnoses. Completed review results will be posted to the Palmetto GBA website. Individual providers with significant denials may be contacted for one-on-one education. 

According to the CMS Program Integrity Manual, Chapter 3, service-specific prepayment probes are described as: “The MACs shall initiate targeted provider-specific prepayment review only when there is the likelihood of a sustained or high level of payment error. MACs are encouraged to initiate targeted service-specific prepayment review to prevent improper payments for services identified by CERT or Recovery Auditors as problem areas.”

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The Annual Meeting & Exposition is Underway.
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NAHC has kicked off the most anticipated conference of the year - the 2013 NAHC Annual Meeting & Exposition in Washington, DC.

Join NAHC staff and leadership, as well as your peers and colleagues Thursday, October 31 – Sunday, November 3, 2013 to hear insightful presentations from a diverse lineup of speakers, learn from valuable educational session topics, and celebrate the many 2013 award recipients, including Nurse of the Year, the Caring Awards, and the Home Care & Hospice Hall of Fame.

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We will be tweeting live during the Annual Meeting & Exposition using the hashtag #NAHC2013. We also encourage you to post your conference pictures to the Facebook page and tag yourself in photos that we post from the meeting.

It’s not too late to register for the meeting by clicking here.

We are looking forward to kicking off a great conference in Washington, DC and we hope you are able to join us!

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Iowa’s Program Integrity Initiative Yields $86 Million in Savings

The National Association for Home Care & Hospice (NAHC) has the pleasure of honoring those who have dedicated their lives to the care and service of others. The Home Care & Hospice Hall of Fame began two years ago when its inductees were honored at NAHC’s largest meeting of the year. This is also NAHC’s second year honoring a Nurse of the Year, the winner of a national vote on nurses from every state.

NAHC’s Nurse of the Year, along with its new Hall of Famers, will be at the 2013 NAHC Annual Meeting & Exposition in Washington, DC, Thursday, October 31 to Sunday, November 3. Attendees will have a chance to meet them and get the tools they need to compete and make their agencies the most successful they can be.

They will also get role models as they learn more about this year’s honorees. The 2013 Home Care & Hospice Hall of Fame inductees are Judith Bellome, Lawrence, KS; Honorable Max Cleland, Arlington, VA; Cathy Frasca, Sewickey, PA; Lori and Paul Hogan, Omaha, NE; Carol Raphael, New York, NY; and, Christopher Reeve, who was a super hero for the paralyzed and mobility impaired.

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