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  NAHC Report: Issue# 2618, 3/9/2015
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Hospice Cap Roundup: Self Calculation and Reporting (2015), the Sequester, and 2013 Cap Determinations
Home Health Care Planning Improvement Act Reintroduced in the House
For Your Information: NAHC’s Legislative Hotsheets Now Available
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Hospice Cap Roundup: Self Calculation and Reporting (2015), the Sequester, and 2013 Cap Determinations

On March 3, the Centers for Medicare & Medicaid Services (CMS) released to the Medicare Administrative Contractors (MACs) the pro-forma spreadsheet and instructions for use by hospices in self-calculating and reporting their aggregate cap.  Beginning with cap year 2014, hospices are required to self-calculate and report their aggregate cap on an annual basis within five months of the end of the cap year (March 31).  Failure by hospices to submit an aggregate cap self-calculation on a timely basis - by March 31, 2015 - and address any related overpayment will result in payment suspension.  It should be noted that the hospice self-calculation will represent an initial cap determination -- since hospice patients may continue on service past the cap year end, CMS will require the MACs to make a final cap determination at a later date that could represent an additional cap-related overpayment liability for the 2014 cap year. 

Since release of the spreadsheet and instructions, the Home Health and Hospice MACs (CGS, National Government Services, and Palmetto GBA) have begun to release information for use by hospice organizations in fulfilling their cap reporting requirement.  While the cap calculation pro-forma spreadsheet and instructions were developed by CMS, hospices are encouraged to use the spreadsheet and instructions issued by their assigned MAC as these instructions may include MAC-specific information, such as information related to where and how the hospice’s self-calculated cap should be submitted to the MAC. 

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Home Health Care Planning Improvement Act Reintroduced in the House

Following the introduction of the Home Health Care Planning and Improvement Act in the U.S. Senate two weeks ago, a companion bill—H.R. 1342—was introduced by Congressman Greg Walden (R-OR) and 15 bipartisan cosponsors in the U.S. House of Representatives on Friday, March 6.  The House bill, which is identical to the Senate bill and legislation introduced last Congress, would allow certain health care professionals other than physicians to sign home health plans of care. For more on the bill’s introduction in the Senate, please see NAHC Report, February 27, 2015.

“Home health care allows patients more control over their health care, and provides a sense of comfort, familiarity, and normalcy for the patient and their families. I know this first hand, because it’s what my parents chose. And it’s not just a win for the patient. Home-based care benefits Medicare as a whole.  Having people recover at home is less expensive than in a hospital or nursing home,” Walden said about the identical legislation last year. Congressman Walden has supported this legislation in past years as well, including in the 113th Congress, when the bill received 162 cosponsors in the U.S. House. The large number of previous cosponsors can be partially credited to NAHC members, who urged their elected officials to support the legislation through NAHC’s Legislative Action Center.

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NAHC’s Legislative Hotsheets Now Available
Hotsheets serve as an important tool to quickly learn about the most important issues affecting the home care and hospice community

NAHC’s Office of Legislative Affairs recently released the Legislative Hotsheets for 2015. The Hotsheets will be used by home care and hospice advocates during the March on Washington. They are designed to help advocates prepare for legislative visits and can also be used as handouts during this year’s March.

They also serve as good primers on the most pressing current issues for the home care and hospice community.

The Legislative Hotsheets are:




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To learn more about the March on Washington, and to register to attend, please click here.  
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