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NAHC Report: Issue# 2318, 11/19/2013
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MedPAC Ponders Hospice Coverage under Medicare Advantage
Medicaid Council Reports on AARP Solutions Forum on HCBS
For Your Information: Hospice Webinar – Additional Data Reporting on Claims
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MedPAC Ponders Hospice Coverage under Medicare Advantage

At its most recent meeting - held November 7-8 - the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare payment policy, discussed ways to ensure better synchronization across Medicare delivery systems, including fee-for-service (FFS), Medicare Advantage (MA), and Accountable Care Organizations (ACOs).  During the meeting, MedPAC staff sought the Commissioners’ guidance on whether to conduct additional study on the advisability of including hospice services as part of MA plans’ benefit package.  Members of the Commission expressed support for the concept of eliminating this “fragmentation”, and it is anticipated that they will discuss the issue further at a forthcoming meeting in December or January.

Since its start as a benefit under Medicare, hospice has been available exclusively as a FFS benefit.  It is believed that the reasoning for exclusion of hospice from coverage by private plans under Medicare is due to the fact that there was insufficient data on hospice costs to establish an add-on to private plan rates for hospice care.  Instead, MA enrollees who choose to elect hospice care historically have been referred to a hospice provider that is paid under the Medicare FFS program.  While on hospice care the patient continues to pay MA premiums and retains coverage of supplemental benefits and Part D, if enrolled, for non-hospice prescriptions, but is covered under the FFS program for standard Medicare benefits under Part A or Part B in addition to hospice services. If a MA beneficiary is nearing the end of life but chooses not to elect hospice, the MA plan is responsible for care. 

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Hospice Webinar – Additional Data Reporting on Claims
Register NOW for this December 4 Session

Since release of Change Request (CR) 8358 (Additional Data Reporting Requirements for Hospice Claims) in July 2013, hospices and hospice industry stakeholders have been wrestling with how to capture the newly required data on the claim. Given the amount and type of data that must be reported beginning April 1, 2014, it’s not too early for hospice programs to begin tackling the significant challenges associated with CR 8358 compliance. The National Association for Home Care & Hospice’s Hospice Association of America is hosting a webinar on Wednesday, Dec. 4 at 1 p.m. EASTERN on this important topic. The registration fee per site is $125; a recorded version of the webinar will also be available for purchase. CEs will be provided.

12/4/13 Online registration form

12/4/13 Product registration form

This webinar will provide the following to participants:

  • Review the four categories of additional data
  • Review the six data elements required
  • Discuss the many outstanding questions
  • Provide practical tips to be used in meeting the new requirements

Faculty will focus on the data elements that are required in order to have a 5010 compliant claim but that are not necessarily evident in the CR, with special emphasis on the drug reporting requirements. A review of questions submitted to CMS and their answers, as we have them at the time of the webinar, will be provided.

Webinar Faculty: M. Aaron Little, CPA, Managing Director, BKD, LLP A CPA and leading national home care and hospice consultant, Aaron has over 15 years of experience with BKD, LLP and specializes in revenue cycle outsourcing and consulting services, as well as compliance and routinely consults with providers and legal counsel on home care and hospice billing compliance matters.

Nationally recognized for his home care and hospice expertise, Aaron serves on the Home Care & Hospice Financial Managers Association (HHFMA) Workgroup. He chairs HHFMA's Young Financial Professionals Committee and is an active member of its subcommittee on revenue cycle matters. He routinely presents for the National Association for Home Care & Hospice (NAHC), HHFMA, Visiting Nurse Associations of America and numerous other regional and state industry organizations and is frequently quoted in industry periodicals.

Aaron's professional affiliations include the HHFMA, American Institute of Certified Public Accountants and Missouri Society of Certified Public Accountants.

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Medicaid Council Reports on AARP Solutions Forum on HCBS

On October 30, 2013, The National Council on Medicaid Home Care – a NAHC affiliate – sent its Resource Center Director Steve Postal attended the AARP Solutions Forum: Modernizing Medicaid: Putting Home and Community-Based Services on Equal Footing with Nursing Homes.  The following are the highlights of the Forum.

The Forum consisted of two panels.  The first was a panel entitled Policies and Challenges and featured:

  • G. Lawrence Atkins, Long-Term Care Commission Staff Director; President, National Academy of Social Insurance;
  • Josefina Carbonell, Senior Vice President for Long-Term Care and Nutrition, Independent Living Systems LLC; and
  • Henry Claypool, Executive Vice President, American Association of People with Disabilities. 

The second panel was entitled Learning from the States and featured:

  • Stephen Kaye, Professor, Institute for Health & Aging, University of California, San Francisco;
  • Charles Milligan, Jr. Deputy Secretary, Health Care Financing, Maryland Dept. of Health & Mental Hygiene; and
  • Jami Snyder, Operations Administrator, Acute and Long-Term Care, Arizona Health Care Cost Containment System.

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