Summary of Palmetto GBA's July 2024 Home Health and Hospice Provider Outreach and Education Advisory Group Meeting
Summary of Palmetto GBA's July 2024 Home Health and Hospice Provider Outreach and Education Advisory Group Meeting
On July 18, 2024, Palmetto GBA held its Provider Outreach and Education Advisory Group (POE-AG) meeting. These forums allow Palmetto GBA to gather input and feedback from provider communities on various topics. POE-AG members provide feedback on provider education and training topics, dissemination methods, and educational forums. The POE-AG meets three times per year to address these issues.
The minutes from the meeting are provided here and below.
Home Health Updates
Palmetto GBA Interactive Voice Response System Has Been Updated
Palmetto GBA has reduced the number of options in the Interactive Voice Response (IVR) system to enhance customer experience and efficiency. Providers from Jurisdictions J and M will now encounter the following four options when calling Palmetto GBA:
- Palmetto GBA Electronic Data Interchange (EDI)
- Provider Enrollment
- Items like claims, financials, eligibility, appeals, or other information
- Providers without a Provider Transaction Access Number (PTAN)
Please note that option “0” has been removed from the main menu.
Effective October 1, 2024, Change Request (CR) 13543 requires that all home health claims report VC 85 and a corresponding FIPS state and county code. Claims lacking this information will be returned to the provider.
Calendar Year (CY) 2025 Home Health Prospective Payment System Proposed Rule Fact Sheet (CMS-1803-P)
A few of the proposals include:
- The Centers for Medicare & Medicaid Services (CMS) estimates that Medicare payments to home health agencies in CY 2025 would decrease in the aggregate by 1.7%, or by about $280 million.
- Proposed occupational therapy Low Utilization Payment Adjustment (LUPA) add-on factor and related updates.
- CMS is proposing to add providers and suppliers that are reactivating their Medicare billing privileges to the categories of new providers and suppliers subject to additional oversight.
Home Health Review Choice Demonstration (RCD) Extended Five More Years
Effective June 1, 2024, CMS will extend the Review Choice Demonstration for Home Health Services for an additional five years. The demonstration will continue in the current demonstration states of Illinois, Ohio, Texas, North Carolina, Florida, and Oklahoma.
As part of the extension, CMS removed "Choice 3: Minimal Review with 25% Payment Reduction" from the initial choice selections. Palmetto GBA has proactively reached out to coordinate with the small number of affected providers to make a new review choice selection beginning July 1, 2024.
Submit Home Health RCD Pre-Claim Review Requests With Your Correct PTAN
Palmetto GBA is seeing an increase of pre-claim review (PCR) submissions with incorrect PTANs, also known as CMS Certification Numbers (CCNs).
Monthly RCD Provider Webinar Schedule
- Wednesday August 7, 2024
- Wednesday, September 4, 2024
- Wednesday, October 2, 2024
Coming Soon
With Palmetto GBA’s transition to Cvent for educational webinars, they are beginning to develop on-demand webinars. The first webinar to be produced for home health providers covers home health physician documentation.
Upcoming Education
Registration is now open for the 2024 Home Health and Hospice Medicare Administrative Contractor Collaborative Summit! This national Medicare event includes all three MACs, more than 40 live speakers, presenting a rigorous, three-day comprehensive conference.
eServices
eServices Displays Accountable Care Organization (ACO) Model Information
On January 2, 2024, eServices made an update to display information on the ACO models for Part A, Part B, and home health and hospice providers that are participating in an ACO. A new menu tab, ACO, will display to provider account administrators.
Open Discussion
- Question: Another home health MAC posted an article about documenting changes of a home health certifying physician or non-physician practitioner (NPP) during an admission. Is Palmetto GBA posting an article like that?
- Answer: Yes. Since the date of this POE-AG meeting. The article, Home Health Certifying Provider Change, has been posted.
Next Meeting
The next POE-AG meeting is scheduled for Thursday, October 10, 2024.