NewsLine - September 2013 - (Page 34)

Tip of the Month Change of Designated Hospice: Revisiting the Regs T he federal hospice regulations allow a patient to transfer from one hospice provider to another (i.e., to “change the designated hospice”) once during each benefit period. The decision to transfer to another hospice provider is the right of the patient or his/ her representative under the Medicare Hospice Benefit. It is not considered a revocation of the election of hospice services and, thus, the patient remains in the same benefit period. Note too that hospice providers may not refuse to transfer a patient or have a “no transfer” policy in place in their organization.1 To transfer to another hospice provider, the patient or his/her representative must file a signed statement with the hospice from which the patient has received care as well as with the newly designated hospice. The signed statement must include the name of the hospice from which the patient has received care; the name of the hospice from which the patient plans to receive 34 NHPCO NewsLine care; and the date the change will be effective.1 If there will be a significant break in service during the transfer, a discharge is recommended versus a transfer. Suggestions for a Smooth Transfer • Communicate with the receiving hospice as soon as possible to coordinate the transfer date and share necessary information about the patient. • Share the following documents with the receiving hospice: signed transfer statement from the patient/ representative; signed notice of hospice election statement from the patient/ representative; current certification materials, including the face-to-face attestation for the current benefit period as applicable; and advance directive documents and/or the DNR. • Code the transfer correctly: For transfers to another hospice provider, use discharge status code 50 or 51; the claim does not terminate the patient’s current hospice benefit period. The receiving hospice must also submit a transfer notice of election (type of bill 8xC) after the transfer has occurred, and the beneficiary’s hospice benefit is not affected.2 Further Reading A Hospice Provider’s Guide to Live Discharges, NewsLine (September 2012). Hospice Discharge, Revocation, and Change of Hospice (November 2012). This is a pocket-size guide available through NHPCO Marketplace for $11.95. 1 CMS Medicare Benefit Policy Manual (Chapter 9): Coverage of Hospice Services Under Hospital Insurance: 20.2 - Election, Revocation, and Change of Hospice. 2 CMS Medicare Claims Processing Manual (Chapter 11): Processing Hospice Claims: 30.3-Data Required on the Institutional Claim to Medicare Contractor https://www.nxtbook.com/nxtbooks/nhpco/newsline_201209/#/0 https://www.nxtbook.com/nxtbooks/nhpco/newsline_201209/#/0 https://netforum.nhpco.org/eweb/DynamicPage.aspx?Site=NHPCO&WebKey=cc62aafb-ae2c-4567-bc55-bf0045abf293&ListSearchFor=Hospice%20Discharge https://netforum.nhpco.org/eweb/DynamicPage.aspx?Site=NHPCO&WebKey=cc62aafb-ae2c-4567-bc55-bf0045abf293&ListSearchFor=Hospice%20Discharge https://netforum.nhpco.org/eweb/DynamicPage.aspx?Site=NHPCO&WebKey=cc62aafb-ae2c-4567-bc55-bf0045abf293&ListSearchFor=Hospice%20Discharge http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c09.pdf http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c09.pdf http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c11.pdf http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c11.pdf

Table of Contents for the Digital Edition of NewsLine - September 2013

Hospice of Hope's Expansion into LTC
A Message From Don
VSED and Hospice Care: A Case Study
A Q&A With Judith Fox
Glatfelter Healthcare (display ad)
Simione Consulting (display ad)
2013 Circle of Life Honorees
Quality Reporting: A Look Back at the First Year
GSA Scientific Meeting (display ad)
HAN Intensive Participants
New Report on WHV Partner Achievements
Free Resources for Pain Awareness Month
Member News and Notes
Compliance Tip
Virtual Conference: Nov 4-8 (display ad)
Videos Worth Watching
Links to Resources on the NHPCO Website

NewsLine - September 2013