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Updates From the Medicare Contractor: NGS

National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently posted the following information to its website.

  • Impact of Sequestration on Hospice Aggregate Cap – NGS has drafted a notice that includes an example informing hospice providers of how sequestration will be handled within the aggregate cap determinations starting with the 2013 cap calculation and beyond. NGS will calculate the aggregate cap determinations by adding the sequestration and net reimbursement amounts together found on the Provider Statistical and Reimbursement (PS&R) report to determine the pre-sequester reimbursement amount. The pre-sequester reimbursement amount will be compared to the allowable Medicare payment amount which will determine the hospice’s pre-sequester payment in excess of the cap amount. If there is a pre-sequester payment in excess of the cap, that amount will be reduced by 2 percent. This amount cannot be greater than the sequestration amount found on the PS&R report. Therefore, these two amounts will be compared and the lesser of the two will be applied to the calculation.

  • Certifying Home Health Care Webinar – On August 24, from 12:30 to 2 p.m., NGS will conduct a webinar on patient/beneficiary eligibility, face-to-face (F2F) encounters and certification requirements as per the 2015 CMS Medicare home health benefit regulations. To register, visit, then click on “HHA” for Home Health & Hospice and select “Accept.” Once in the portal, you can click the Training Events Calendar link under the Education and Training tab.

For further information, contact Patrick Conole at (518) 810-0661 or