Welcome to NHPCO's Regulatory & Compliance Center
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NHPCO members have the benefit of being informed about all of the current regulatory and compliance issues in the hospice industry. Topic areas are available by clicking on the box for the subject area below. Additionally, compliance and regulatory news goes out to members via the following NHPCO resources:
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Click the button to access listed information. Take a tour of the Regulatory & Compliance Center information by clicking on the “Download a web page tip sheet” button.
Be sure to read the article in May NewsLine that recaps key regulatory changes—and clarifications from CMS. The article also includes quick links to the relevant Regulatory Alerts, so members can learn more about a particular issue with the click of their mouse: Digital edition; PDF (see page 8).
Click the button to access listed information. Take a tour of the Regulatory & Compliance Center information by clicking on the “Download a web page tip sheet” button.
Hospice Compliance Calendar
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| JAN 1, 2011 |
!80 day Face to face physician/ NP patient visit for recertification. |
| DEC 31, 2010 |
The FTC is further delaying enforcement of the “Red Flags” Rule through December 31, 2010, while Congress considers legislation that would affect the scope of entities covered by the Rule. |
| OCT 1, 2010 |
CR 6905: Effective for claims with dates of service on or after October 1, 2010, hospices will report HCPCS Q5010 when Routine Home Care (RHC) or Continuous Home Care (CHC) is provided at a hospice residential facility or a hospice facility which is also certified to provide inpatient care. |
| OCT 1, 2010 |
CR 6960: Section 6404 of the Patient Protection and Affordable Care Act (PPACA) amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year (12months) after the date of service. |
| OCT 1, 2010 |
HIPAA 5010 Activity – Testing of 5010 CRs - The second portion of the CRs listed on the attachment "STC Testing Schedule.xls" will be tested. |
| JULY 6, 2010 |
CR 6778: System edits that will become effective for claims submitted on or after July 6, 2010
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| APRIL 29, 2010 |
For hospice claims submitted on or after April 29, 2010, hospices should report separate line items for the level of care each time the level of care changes. This includes revenue codes 0651 (Routine Home Care), 0655 (Inpatient Respite Care) and 0656 (General Inpatient Care). |
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APRIL 1, 2010
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CR6540: The hospice provider must report the National Provider Identifier (NPI) of the attending physician/NP in the attending physician field on the NOE and claim with effective dates or dates of service on or after April 1, 2010. (CMS) |
| JAN 1, 2010 |
CR 6740: Hospice services provided by physicians must use the most appropriate E/M codes to bill for E/M services. CMS clarifies that CPT consultation codes are no longer valid for hospices, even when physician services are provided under Medicare Part A.
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JAN 1, 2010
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CR 6440: Mandatory submission of hospice phase 3 data on the patient claim form per instructions in CR 6440, CMS.
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JAN 1, 2010
Optional compliance date
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CR6540: The hospice provider must report the National Provider Identifier (NPI) of the attending physician/NP in the attending physician field on the NOE and claim with effective dates or dates of service on or after January 1, 2010. (CMS) |
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JAN 1, 2010
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CR 6740: Part B carriers and/or A/B MACs will no longer recognize AMA CPT consultation codes (ranges 99241-99245, and 99251-99255)
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NOV 1, 2009
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Small businesses and other entitles now have until November 1, 2009 to comply with the Federal Trade Commission’s (FTC) “red flags” rule, which requires physicians to institute policies to identify, detect and respond to potential risks of identity theft.
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OCT 1, 2009
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Physician certification of terminal illness narrative (CMS must be included as a part of the certification form).
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OCT 1, 2009
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CMS FY 2010 Medicare and Medicaid hospice rates went into effect. |
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OCT 1, 2009
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Optional submission of hospice phase 3 data on the patient claim form per instructions in CR 6440, CMS.
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OCT 1, 2009
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New physician specialty code for hospice and palliative care effective. |
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SEP 30, 2009
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All DME vendors must be DMEPOS accredited.
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Additional Helpful Links:
This is one of the most important times for professionals and providers to stay up to date on new regulatory issues that are being released. Information, materials and analysis from NHPCO will help providers better understand and implement these regulatory issues.
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