Updates from NGS Hospice Advisory Meeting

Situation Report | June 22, 2020

National Government Services (NGS), New York’s Medicare Administrative Contractor, convened its most recent quarterly meeting of associations for updates on hospice reimbursement, audits and regulations. The meeting, on June 18, followed a similar one for home health the week prior.

HCA Vice President for Finance and Management Patrick Conole has written a memo summarizing key updates for HCA’s hospice members.

The memo includes several links to COVID-19 resources by NGS and the U.S. Centers for Medicare and Medicaid Services (CMS).

Also, NGS has reported a Comprehensive Error Rate Testing (CERT) of 4.63 percent for hospice in Jurisdiction 6, which includes New York and several other states/territories.

The memo outlines some of the top CERT denial reasons. It also summarizes the top three denials stemming from the Targeted Probe and Educate (TPE) audit process. While TPE is currently suspended, due to the public health emergency, it focuses on billing requirements that providers must abide, irrespective of a particular audit initiative.

In addition, NGS reviewed some upcoming education programs. The content review portions provided some especially important background on the hospice election statement and addendum requirements for fiscal year 2021.