In June, CMS made a clarification to a previous transmittal which allows clinical nurse specialists, physician assistants, and nurse practitioners to certify eligibility and order services under the Medicare home health benefit. These individuals, of course, are defined as allowed practitioners. The CMS Transmittal 11447 replaced Transmittal 11386 (previously released in April 2022) and stated…
Tag: eligibility
Hospice Certification
As scrutiny of hospice organizations increase, it’s particularly important for hospices to ensure their certifications and recertifications of terminal illness meet all required elements. In the 2021 Medicare FFS Supplemental Improper Payment Data report of improper payments, the top cause for error was “insufficient documentation of the physician’s certification/recertification”. A few short months from now,…
Hospice Benefit Eligibility
Just last month, the Office of Inspector General (OIG) announced its intent to perform a nationwide review of hospice beneficiary eligibility. This action was in response to identified recent negative findings during individual provider audits by the Office of Audit Services. In their audits, they found a pattern of patients who did not meet eligibility…
