The Office of the Inspector General (OIG) noted that hospice election statements lacked required information or had other vulnerabilities in more than one-third of general inpatient care stays. Notably, many did not mention, as required, that the beneficiary was waiving coverage of certain Medicare services by electing hospice care or that hospice care is palliative rather than curative. Please see MLN Matters Special Edition Article SE1628 for requirements about hospices and election statements. Model Medicare Hospice Election Statement language is included at the end of this article.
Effective Date: January 1, 2017
Implementation Date: January 3, 2017
Occurrence span code 77 is currently used for both late re-certifications and late NOE’s, and the Medicare system is having difficulty distinguishing when the 27 certification date should fall within the 77 span dates or not. Change Request (CR) 9590 creates a new condition code for hospices to use to identify when an occurrence span code 77 period is caused by a late recertification of the terminal illness. Note that CR9590 creates no new policy.
The new condition code 85 is effective on January 1, 2017 and is defined “Delayed recertification of hospice terminal illness.” When hospices report this code, Medicare systems will ensure the occurrence code 27 date does not fall within the OSC 77 dates. Your 27 code date will be the actual recertification date, which should fall the date after the occurrence span with the 85 Code.
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Is your hospice small enough to be exempt from Hospice CAHPS? Deadline for the application for exemption is looming!
For the calendar year (CY) 2016 data collection period, Medicare-certified hospices that have served fewer than 50 survey-eligible decedents/caregivers in CY 2015 (January 1, 2015 through December 31, 2015) can apply for an exemption from CAHPS Hospice Survey CY 2016 data collection and reporting requirements.
Hospice CAHPS® Exemption for Size Deadline: August 10
Exemptions on the basis of size are active for one year only; you must resubmit an application even if you applied last year.
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