tci Medicare Compliance & Reimbursement - 2015 Issue 17
Reimbursement: Get More Medicare Pay for Concurrently Providing Hospice & Curative Services
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Article Overview
This article explains a CMS demonstration model affecting hospice and related Medicare reimbursement, including who can participate, what broad categories of services may be involved, and the phased rollout timeline. It is aimed at hospice administrators, billing and reimbursement staff, and other providers serving Medicare and dually eligible beneficiaries who want to understand why the model matters and how it changes the care landscape.
Why This Topic Matters
The article matters because it describes a CMS model that changes how some beneficiaries can receive supportive hospice-related services alongside ongoing treatment, with implications for provider participation, patient access, and reimbursement under Medicare and Medicaid.
Article Sections
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Would Your Patients be Interested?
Introduces the Medicare Care Choices Model and explains the general purpose of the CMS initiative. It also summarizes the participation expansion and the broad care-planning goals described by the sources cited in the article.
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Why Hospice Providers are Enthused
Describes why hospice organizations are interested in the model and includes provider perspectives on what participation may mean for patients and care delivery.
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Get Fair Payment for These Services
Summarizes the general reimbursement framework discussed for participating hospices and other providers, including the categories of services involved under the model.
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What Types of Beneficiaries are Eligible?
Outlines the broad beneficiary eligibility framework and the categories of patients described as eligible for participation in the model.
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Timeline
Provides the implementation schedule and end date for the model as described in the article.
What You Will Learn
- The purpose and scope of the Medicare Care Choices Model
- Which provider types may be affected by the model
- The broad categories of services associated with the demonstration
- The general eligibility framework for participating beneficiaries
- The implementation timeline and duration of the model
Who Should Read This
- Hospice administrators
- Billing and reimbursement professionals
- Revenue cycle staff
- Palliative care providers
- Medicare-participating healthcare organizations
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