Home Health

CMS creates resource page for hospice VBID

CMS has created a special online resource page for the hospice Value-Based Insurance Design (VBID) demo. This page relays key information related to the model, including: an overview, coverage information, participating plans, billing and payment information, outreach and education and frequently asked questions.

CMS is testing the inclusion of the Part A Hospice Benefit within the Medicare Advantage (MA) benefits package through the Hospice Benefit Component of the VBID, CMS states. This test allows CMS to assess the impact on care delivery and quality of care, especially for palliative and hospice care, when participating MA plans are financially responsible for all Parts A and B benefits.

The top three things hospice providers need to know include:

  • Notices and claims must be sent to both the participating MAO and your MAC. The MAO will process payment, and the MAC will process the claims for informational and operational purposes and for CMS to monitor the Model.
  • If you contract to provide hospice services with the plan, be sure to confirm billing and processing steps before January 1, 2021.
  • The model does not allow prior authorization requirements around hospice elections or transitions between different levels of hospice care.

Related link: View the resource page at: https://innovation.cms.gov/innovation-models/vbid-hospice-benefit-overview.