Federal News and Information

Internal Revenue Service (IRS)

Hospice providers need to be aware that the IRS has announced an increase in the optional standard mileage rate for the final 6 months of 2022. Taxpayers may use the optional standard mileage rates to calculate the deductible costs of operating an automobile for business and certain other purposes.  For the final 6 months of 2022, the standard mileage rate for business travel will be 62.5 cents per mile, up 4 cents from the rate effective at the start of the year.  If you would like to read the entire article, go to:

https://www.irs.gov/newsroom/irs-increases-mileage-rate-for-remainder-of-2022#:~:text=For%20the%20final%206%20months%20of%202022%2C%20the%20standard%20mileage,the%20start%20of%20the%20year.

 

Centers for Medicare and Medicaid Services (CMS)

Reminders

Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Changes

The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare Fee-for-Service (FFS) claims:

  • No payment adjustment through March 31, 2022
  • 1% payment adjustment April 1 – June 30, 2022
  • 2% payment adjustment beginning July 1, 2022

Survey Compliance for Staff Vaccination: CMS Update

QSO-22-17-ALL Surveys for compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements was released on June 14, 2022.  Survey oversight of the staff vaccination requirement for Medicare and Medicaid certified providers and suppliers will continue to be performed during initial and recertification surveys but will now only be performed in response to complaints alleging non-compliance with this requirement, not all surveys.  Prior QSO guidance advised that all surveys included oversight of the staff vaccination requirement.  CMS plans to revise QSO 22-11 to ensure deficiency determinations reflect good faith efforts implemented by providers and suppliers and incorporate harm or potential harm to patients and residents resulting from any non-compliance.  To review the QSO, go to:   https://chapinc.org/wp-content/uploads/2022/06/QSO-22-17-ALL.pdf.

 

Palmetto

CY 2022 Physician Fee Schedule

The physician fee schedules have been posted for New Mexico and Texas!  Fees are based on the CY 2022 Medicare Physician Fee Schedule (MPFS) Final Rule. These fees are effective January 1, 2022.Go here:  https://www.palmettogba.com/palmetto/jmhhh.nsf/DID/WBGYES6FHL#ls.

Hospice Coalition Questions and Answers: October 7, 2021

Palmetto has posted the questions and answers posed to them by the Hospice Coalition! Topics are:  billing and medical review. Posting has been behind schedule.   It has met several times since the above date.   The next meeting is in October 2022.   To review the Q&A, go to:

https://www.palmettogba.com/palmetto/jmhhh.nsf/DID/BDXE8AR6GN#ls.

 

Texas News and Information

TNMHO updated the following FAQs and posted them to the Members Only site:

  • Consent to Antipsychotic or Neuroleptic Medications in the NF
  • Certified Nurse Aide and Hospice Aide: What’s what?
  • Hospice Social Work Supervision and Interns
  • Using Interns as Volunteers in Hospice
  • Medicaid Hospice Contracting
  • Preadmission Screening and Resident Review (PASRR)

TNMHO has removed:

  • Vaccine Preventable Diseases and the Hospice Provider. All rules address this issue among provider types and those contracting to provide services.

Texas Office of Inspector General

The OIG shared a very pertinent article explaining exclusion lists, provider actions that lead to exclusion and its consequences for Medicaid providers.

OIG exclusions list helps providers protect their patients

The OIG exclusions list simplifies applicant screening for Texas Medicaid providers, offering the ability to better protect their patients with real-time verification of potential employees before they are hired.

Texas Health and Human Services (HHS) Office of Inspector General (OIG) protects the health and welfare of people receiving Medicaid by preventing certain people or businesses from participating as service providers. Medicaid providers are responsible for making sure they don’t employ individuals listed on the state or federal OIG exclusion lists. The requirement applies to not only the health care practitioners, such as nurses and other direct care providers, but also to employees such as front office staff.

What leads to exclusion?
Federal and state OIGs may prohibit people or businesses from participating as Medicaid providers for several reasons, including Medicaid fraud convictions, patient abuse, Medicare program exclusion or licensing issues with any licensing boards for health care practitioners, such as the Texas State Board of Dental Examiners, Texas Medical Board or Texas State Board of Pharmacy. In fiscal year 2021, the Texas OIG excluded 201 providers of all types from HHS program participation. Typical actions across provider types that lead to exclusion include:

  • Forging documentation and colluding with clients to bill and share payments for services not rendered
  • Billing for false claims
  • Illegal Medicaid client solicitation

Physician exclusions typically arise at the OIG due to a criminal conviction through the Medicaid Fraud Control Unit at the Office of Attorney General or a notice from the Centers for Medicare & Medicaid Services.

The consequences of exclusion
When a person or entity is excluded from Medicaid or other HHS programs, they may not be reimbursed for providing goods or services or request or receive payment for services performed under Medicaid or any other HHS program. Excluded providers may not assess care or prescribe services to clients who use HHS programs. A provider employing an excluded person may not bill Medicaid or any other HHS program for the excluded employee’s services. Submitting claims for payment for an excluded employee’s services could result in recoupment of any compensation paid to the ineligible worker, program termination, program exclusion or monetary penalties imposed.

An employer’s responsibility
The OIG settled a case in December against a medical provider who employed an excluded individual. The provider had checked the list at the time of hire, but the individual was added to the exclusion list two months later. The provider worked collaboratively with OIG Litigation to resolve this issue, and the OIG agreed to a settlement of $1,095.

Many exclusion cases come to the OIG through a provider’s self-reports, but the OIG also initiates exclusion reviews. An initiative in 2020 identified three providers who were given the opportunity to self-identify the errors and the length of time the excluded individuals were employed. The violations among the three providers were settled for $163,532.

Providers are encouraged to screen all employees for exclusion from Medicaid on a monthly basis. The Texas Exclusions List is updated daily. You can access the state list on the OIG website:

https://oig.hhs.texas.gov/exclusions.

 

 

Disclaimer:  The Texas and New Mexico Hospice Organization publishes the Regulatory Update as an information only item.  TNMHO has no attorneys nor does it represent the state and federal governments.  All legal questions or concerns should be directed to your attorney or the governments involved.