Situation Report | December 14, 2020
Last week, National Government Services joined two other hospice Medicare Administrative Contractors (MACs), Palmetto GBA and CGS Administrators, LLC, on a webinar about “Understanding the Hospice Election Statement Addendum.”
The U.S. Centers for Medicare and Medicaid Services (CMS) finalized modifications to the hospice election statement in its fiscal year (FY) 2020 Hospice Final Rule in order to increase coverage transparency for beneficiaries electing hospice care. An election statement addendum must also be furnished upon request by the beneficiary or the beneficiary’s representative if and when the hospice determines there are conditions, items, services, or drugs that are unrelated to the individual’s terminal illness.
These changes became effective for hospice elections beginning October 1, 2020.
While the addendum is only given to Medicare hospice beneficiaries (or their representatives) when they request the information, it becomes a condition of payment when that occurs and is subject to MAC medical review.
Besides the educational background on the addendum, the three Hospice MACs also offered examples of correct and incorrect addendums and multiple addendum resources which should assist hospices in completing the addendum correctly to avoid any payment denials in the future. The webinar also included live questions and answers.
The next webinar of this kind will be on January 19. Registration is here.