Hospice

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  • 1.  Prepayment Review Expansion

    Posted 09-05-2024 04:39 PM

    Just saw this cryptic note in CMS's MLN Connects Newsletter published today, 9/5/24:

    "To combat fraud, waste, and abuse under the hospice benefit, CMS will expand prepayment medical review this September in Arizona, California, Nevada, and Texas. To help reduce burden on compliant providers, initial review volumes will be low and adjusted based on results. 

    If you're noncompliant, we may implement extended review or take additional administrative actions."

    Prepayment review was already in place for new providers.  Does this mean it's now in effect for existing providers in these 4 states as well?

    Bob Banerjee



    ------------------------------
    Bibhuti Banerjee MBA
    President
    Shanti Hospice
    Chandler AZ
    +1 (480) 788-7284
    ------------------------------


  • 2.  RE: Prepayment Review Expansion

    Posted 09-05-2024 05:21 PM

    We have inquired with CMS about this (post immediately below) and are trying to obtain more information. It does seem that this is intended to apply to existing providers, We are investigating further and will provide updates as we receive them. 



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    Katie Wehri
    Vice President of Regulatory Affairs, Quality & Compliance
    NAHC
    Washington, DC
    202-240-9254 #3360
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    Original Message


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