NGS Updates

National Government Services, New York’s principal home health and hospice Medicare Administrative Contractor (MAC), has recently posted the following information.  

Hospice End of Life SIA Payment

Hospice claims are being adjusted with the expectation of receiving the End of Life (EOL) Service Intensity Adjustment (SIA) payment for eligible services that occurred the month prior and within seven days of the beneficiary’s date of death. Due to changes implemented in the Fiscal Intermediary Standard System (FISS) with the January release, the adjustments are not paying correctly. At this time, providers are being asked to use the following workaround: adjust the discharge claim with patient status code 40, 41, and 42 and post the DOD IND “Y” on the beneficiary header and then adjust the prior month’s bill to pay the add-on. 

Hospice Claims Overpaying Routine Home Care Days

A minimal number of claims with Routine Home Care (RHC) days are overpaying at the high routine home care rate when the prior days used are greater than 60 days (hospice claims with type of bill 817 and 81I). This issue is being researched. 

July 2020 Refresh of Home Health Compare Will Not Occur

Beginning January 1, 2020, the U.S. Centers for Medicare and Medicaid Services (CMS) is processing all Home Health OASIS submissions and all reporting requirements through iQIES. Due to unforeseen circumstances, CMS has determined that there will not be a refresh for the Home Health Compare website in July 2020. Because of this, CMS will not release the Home Health Provider Preview Report for the July 2020 refresh in March. The next scheduled refresh for the Compare site will be in October 2020.  

The publicly reported home health data published for April 2020 will remain in place until the October 2020 refresh.  Home health providers can expect to receive their next Provider Preview Report in late June of 2020 for the October 2020 Compare site refresh. For questions, please contact CMS at iqies@cms.hhs.gov.