National Government Services (NGS), New York’s home health and hospice Medicare administrative contractor (MAC), has suspended its Targeted Probe and Educate (TPE) Medical Reviews for home health and hospice providers due to the COVID-19 emergency.
NGS states that it is unable to provide additional clarity on when or how TPE reviews will resume but will share information as it is made available. NGS will also work with providers on rescheduling any previously scheduled TPE educational sessions.
NGS is contacting providers to let them know they have released Medicare claims and there is no need to respond to any Additional Development Request (ADR) for medical records. Beginning April 1, 2020, Medicare claims that auto-denied for non-response or late response to the ADR will be reversed and allowed for payment unless an appeal has already been filed. In that case, the appeal will follow the normal appeals process.
NGS’s e-mail address remains available for questions specific to medical reviews at j6probeandeducate@anthem.com.