COVID-19 Resource Center
HOSPICE: Non-Cancer Length of Stay (NCLOS) Rates, Palmetto GBA, April 16, 2020--This electronic Comparative Billing Report (eCBR) focuses on Non-Cancer Length of Stay (NCLOS) rates from October 1, 2019, to March 31, 2020. CBR information is one of the many tools used to assist individual providers to become proactive in addressing potential billing issues and performing internal audits to ensure compliance with Medicare guidelines. Please share with appropriate staff.
HOSPICE: Hospice Payment Rate Update Proposed Rule for FY 2021, CMS MLN Connects, April 16, 2020--On April 10, CMS issued a proposed rule (CMS-1733-P) that would update FY 2021 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. This rule provides model examples of the hospice election statement and the hospice election statement addendum that reflect the changes finalized in the FY 2020 hospice final rule for elections on or after October 1, 2020.
For More Information:
HOSPICE: Hospice Coalition Questions and Answers, Palmetto GBA, April 16, 2020--The February 13, 2020, Hospice Coalition Questions and Answers are now available. Please review and share this information with your staff.
HOSPICE: Calls Grow Louder to Delay Hospice Medicare Advantage Carve-In, Hospice News, April 17, 2020--Stakeholders in the hospice space are calling on the U.S. Centers for Medicare & Medicaid Services (CMS) to delay the inclusion of hospice in the agency’s value-based insurance design model, commonly called the Medicare Advantage hospice carve-in, on the grounds that providers will not be able to prepare due to the pressures brought on by the ongoing pandemic.
HOME HEALTH: RAP Auto Cancellation Extension Confirmed, Palmetto GBA – Part of the 1135 waivers that CMS approved for home health allowed the Medicare MACs to extend the amount of time that agencies would have to get a final claim filed without the RAP auto cancelling and being taken back. The following is from the Palmetto GBA website: As stated in MLN Matters Number SE20011, Medicare Administrative Contractors (MACs) are allowed to extend the auto-cancellation date of Requests for Anticipated Payment (RAPs). Palmetto GBA has extended the auto-cancel timeframe of RAPs by 90 days from the paid date of the RAP, retroactive to March 1, 2020. This means 150 days from the date the RAP is paid. The normal is 60 from the date it is paid and they have added 90.
HOME HEALTH: What Has Changed for Home Health During the Public Health Emergency?, NAHC Report, April 10, 2020 – On March 30, 2020, CMS issued an interim final rule with comment (IFC) that provides relief from regulations governing health care provider operations in response to the COVID -19 pandemic. NAHC has completed three sets of frequently asked questions and answers (FAQs) on the topics of: Telehealth; Non-physician practitioners (NPPs) certifying and ordering home health services, and Waivers on the Conditions of Participation.
HOME HEALTH: ODA and ODM Response to COVID- 19: Updated April 13, 2020 - The Department of Aging (ODA) and the Department of Medicaid (ODM) provided initial guidance to implement emergency protocols as part of the State’s response to COVID-19. This is a companion document to answer specific questions. All guidance and protocols must be forwarded and shared with all appropriate staff. Please note, this is intended to be a living document and will be updated periodically.
HOME HEALTH and HOSPICE: COVID-19 Managed Care Plan Emergency Provisions April 9, 2020 – The Ohio Department of Medicaid (ODM), in collaboration with the Medicaid Managed Care Plans (MCPs) and MyCare Ohio Plans (MCOPs), has implemented emergency provider agreement changes affecting pharmacy benefits, telehealth services and service authorization requirements. These changes are intended to remove barriers to care, and to safeguard individual health and wellbeing while reducing burdens on Medicaid providers.
A few changes that affect HH and Hospice are:
- MCPs and MCOPs are extending timely filing limits to accept claims from all provider types for up to 365 calendar days from the date of service.
- Effective March 27, 2020, ODM managed care plans will defer medical necessity determinations to providers; and
- No authorization is required
>>>RCD/PDGM UPDATES –
CANCELLED – OCHCH WEEKLY PDGM/RCD CALLS - FRIDAY, April 24 & May 1, 2020
If you have PDGM or RCD QUESTIONS PLEASE SEND THEM TO firstname.lastname@example.org
Use PDGM or RCD as the subject title.
If you need OCHCH to contact Palmetto GBA regarding a PCR NON-AFFIRMATION,
Please e-mail a short description and the UTN and your provider number.
DO NOT e-mail any info that could be non-compliant with the HIPAA regulations
Please check out the toolkits for PDGM and also RCD!
>>>RCD UPDATES –
RCD Tip: Using the Correct Provider Transaction Access Number (PTAN), Palmetto GBA – If you are a part of a Home Health Agency (HHA) with more than one location and multiple PTANs, please make sure you are using the correct PTAN when submitting Pre-claim Review (PCR) requests.
RCD for Ohios Home Health Services Has Been PAUSED
Ohio Providers Transition to Review Choice Demonstration (RCD) Cycle Two, Palmetto GBA – Beginning May 1, 2020, you will be able to choose the next round’s review option. Typically, the selection period is open for a two-week period. Due to the current Public Health Emergency (PHE) related to COVID-19, the last day to make a selection has not yet been determined. Palmetto GBA will announce the last day to make a selection as soon as possible on our website and via email update. If you are not signed up for the Palmetto GBA email updates, please visit https://tinyurl.com/GetListserv to sign up.
Save the date for a WEBINAR – “Ohio Providers Transition to Review Choice Demonstration (RCD) Cycle Two by Palmetto GBA, Friday, May 1, 2020 – 10am-11:30am