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  NAHC Report: Issue# 2835, 2/1/2016
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Some Hospices Receiving SIA Payments Incorrectly
CDC Uniform Definitions and Recommended Data Elements to Address Elder Abuse Released
For Your Information: NAHC Announces the March on Washington Conference
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Some Hospices Receiving SIA Payments Incorrectly

Effective January 1, 2016, the Centers for Medicare & Medicaid Services (CMS) implemented a new payment system under which hospices receive one of two per diem rates (high or low) for Routine Home Care (RHC) and may be eligible for Service Intensity Add-on (SIA) payments when Registered Nurse and Social Work service visits are provided during the last seven days of a patient’s life and the patient is cared for at the RHC level. Hospice providers are just beginning to submit claims for services provided during January 2016. The National Association for Home Care & Hospice (NAHC) has received notice from one of the Home Health/Hospice Medicare Administrative Contractors (MACs) that some hospice providers are receiving incorrect SIA payment adjustments related to services provided at the Continuous Home Care (CHC) level of care. As a result, these hospice providers may be receiving overpayments for some of the care days they have billed.

It is believed that this is a nationwide issue, and the processing error has been reported to the Fiscal Intermediary Shared System (FISS) Maintainer. The issue is expected to be corrected with a system fix scheduled for implementation on February 22, 2016. No provider action is required.

NAHC will provide updates on this issue as they become available through future NAHC Report articles and on its member listserv.

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CDC Uniform Definitions and Recommended Data Elements to Address Elder Abuse Released

The Centers for Disease Control and Prevent (CDC) has released “Elder Abuse Surveillance: Uniform Definitions and Recommended Core Data Elements,” which contains proposed uniform definitions and core data elements to allow for better collaboration between experts in addressing elder abuse. A problematic issue in the effort to address elder abuse has been the lack of consistency in the definitions and data elements used across the nation.

“Longstanding divergences in the definitions and data elements used to collect information on Elder Abuse (EA) make it diffi­cult to measure EA nationally, compare the problem across states, counties, and cities, and establish trends and patterns in the occurrence and experience of EA,” CDC stated.  “To help remedy these problems and promote public health surveillance of EA, [CDC] and a diverse group of EA experts collaboratively produced version 1.0 of uniform definitions and recommended core data elements for possible use in standardizing the collection of EA data locally and nationally. Proposed uniform definitions were developed for the following phenomena (and for associated terms or elements that could be sources of confusion or disagreement).”

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NAHC Announces the March on Washington Conference
Mayflower Renaissance Hotel, April 4–5, 2016

NAHC is hosting the 2016 March on Washington Conference in the splendid city of Washington, DC. Now is a critical point as we face new rules that could challenge our mission to serve America’s aged, disabled, and ill. Join us as we work to make home care and hospice the center of health care in our country.

The nation’s capital is the heart of legislative activity that affects home care and hospice. That makes it the perfect place to raise awareness of the vital work we do. Together, we can deliver a unified message to those who make the policies that shape our business. Take advantage of this chance to lobby your lawmakers, connect with colleagues, and attend educational sessions led by experts in our field.

Register and Book Your Hotel!

View the Conference Program!


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