Earlier this month, CMS released new information regarding the development that the hospice VBID demonstration would be terminated, effective December 31, 2024.
With the Hospice portion of the VBID demonstration ending, there were many questions regarding the impact on patients, specifically concerning payers and benefits. CMS provided clarification stating that for claims purposes, these patients will transition back to traditional Medicare on January 1, 2025.
The transition for hospices should be very smooth, as they will continue using the same documentation and billing procedures for traditional Medicare as they did under the VBID model. This includes filing the Notice of Election within the five-day window. Starting in January, instead of submitting claims to the Medicare Advantage plan, hospices will simply send them to traditional Medicare (Medicare MACs – Palmetto, CGS & NGS).
Agencies must continue providing the same Hospice Benefit to patients as they currently do, and ensure that all the requirements of traditional Medicare Hospice are met.
Please be aware that any benefits your patient received under the VBID model will end on December 31. This includes any supplemental benefits provided through participation in the Hospice VBID demonstration. Transitional Concurrent Care will no longer be available after December 31, and any palliative care received outside of the standard Hospice benefit will also end on that date.
Medicare Advantage plans participating in the VBID demonstration have been instructed to inform patients about the December 31 deadline ending their Hospice benefit under that specific payer. However, payments to the Hospice will continue to be made through traditional Medicare.
There has been some confusion about how this transition would happen, but since hospice billing is done on a calendar month basis, the transition should be straightforward. Starting January 1, you will only need to bill Medicare through the Medicare Administrative Contractors (MACs) — Palmetto GBA, CGS, and NGS — for your January claims.
HPS stands ready to help your agency with hospice billing, regardless of the payer. Should you need assistance, please feel free to reach out to us.
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