Home Health & Hospice Week
Hospice COPs Could Be Out Any Day
But will the long-pending standards get pushed back once again? Hospices will be seeing their fair share of regulatory action in the coming months, judging by the Department of Health and Human Services' new semiannual regulatory agenda.
The Centers for Medicare & Medicaid Services last year pledged that it would re-propose the hospice conditions of participation this month. And in the agenda published in the May 16 Federal Register, CMS still says it will issue a COP proposed rule in May.
Last summer a CMS official told the National Association for Home Care & Hospice that the hospice COPs would come out even earlier than May, but that did not come to pass. Chances are high that the May deadline will slip by again on the standards first proposed in 1997, experts predict.
CMS also expects an interim final rule in May requiring hospices to submit electronic cost reports; a final rule in November with a number of hospice amendments that already have been implemented; and a proposed rule in March 2006 establishing requirements for hospice services in long-term care facilities.
The RHHI is launching the new edit because when it conducted a probe of 100 such claims, it found a high denial rate for patients not being homebound.
A Medicare change request released earlier this year removes an instruction issued last year requiring modifier AU to always be present with code A4217. Now code A4217 without modifier AU will be considered a DME code and processed accordingly. Details are at
The provider of home care and outpatient services has to revise overstated earnings for the last three quarters because of a software error that resulted in sending wrong data to an HMO payor, it says. The company is delaying its latest quarterly results while it confirms that it has fixed the error.
Columbia, SC-based Palmetto was not included in the lawsuit, but in her decision Altonaga questioned why, according to the paper. The company maintains that catching the problem at four months in a program that relies on post-payment analysis indicates its vigilance against fraud and abuse.
The ALJ held that Horras included false claims, including personal expenses, on cost reports from 1995 to 1997. Richards acted with "reckless disregard" to the false claims, the OIG says.
Home Health & Hospice Week
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Hospice COPs Could Be Out Any Day
But will the long-pending standards get pushed back once again? Hospices will be seeing their [...]
