In This Section
Regulatory A to Z

Listing of Regulatory Topics. Hospice Acronym Index.

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Beneficiary Notices and Coverage (ABN NOMNC)

Advance Beneficiary (ABN). Notice of Medicare NonCoverage (NOMNC). Detailed Explanation of Non-Coverage (DENC).

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Billing and Reimbursement

Resources for Medicare billing, physician and NP billing and reimbursement. Medicare and Medicaid Rates. Hospice Cap. Hospice cost report. Q Codes.

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Certification and Recertification

Technical Requirements for Certification, Recertification, Physician Narrative, Face to Face, Attestations. Signatures.

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Data Sources

Data to assist in identifying risk areas. MedPac. NHPCO Facts and Figures. PUF. PEPPER. Proposed Rules.

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Discharges, Transfers, and Revocations

Discharge No Longer Terminal. Discharge Leave the Service Area. Discharge For Cause. Revocation. Transfer (Change) of Designated Hospice Provider. Traveling Patients.

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Election and Admission

Requirements for a Medicare Hospice Election Statement. Election Statement Addendum. Initial and Comprehensive Assessments. Notice of Election (NOE).

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Emergency Preparedness

Emergency Preparedness and CMS. Coronavirus (COVID-19) Public Health Emergency.

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Facility Based Care (SNF, NF and ALF)

Hospice Care in Skilled Nursing Facilities (SNF). Nursing Facility (NF). Assisted Living (ALF) and ICF/IID. Q Codes.

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HIPAA

HIPAA Requirements. Information Blocking Rule.

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Interdisciplinary Team (IDT/IDG) and Care Planning

Role of Physicians, RNs. Social Workers. Chaplains. Counselors (bereavement, dieticians and other). Therapist. Hospice Aides. Core services.

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Levels of Care

Routine Home Care. General Inpatient Care. Inpatient Respite Care. Continuous Home Care. Q Codes.

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Medical Review and Audits

Medical review entities: Medicare Administrative Contractors (MACs). Unified Program Integrity Contractors (UPICs). Recovery Auditors (RA). Special Medicare Review Contractors (SMRC).

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Medicare Hospice Regulations and Federal Resources

Regulations and links to important CMS and other Federal Regulations and Resources. Medicare Conditions of Participation. Medicare Conditions of Payment. Medicaid.

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Opioids

Prescribing. Drug Disposal.

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Program Integrity

OIG. OIG List of Excluded Individuals/Entities (LEIE). Fraud and Abuse. Compliance Program Guidance. CMS Fraud and Abuse Contractors. NHPCO Compliance Certificate Program.

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Regulatory and Policy Alerts and Updates from NHPCO

Find NHPCO Regulatory Alerts and Updates. Comment Letters. and Publication Links of importance.

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Relatedness: Conditions, Medications, Drugs, Services

Related and Unrelated Conditions, Medications, Drugs and Dervices. Hospice and Part D.

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State Specific Resources

State Regulations and Laws. Certificate of Need Comparison.

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Survey Readiness and Response

Medicare Survey Process. Survey Readiness. Survey Response. Plan of Correction. Top Survey Deficiencies. Enforcement Remedies.

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Terminal Illness and Related Conditions, Prognosis, and Eligibility

Terminal Illness. Related Conditions. Eligibility. Local Coverage Determinations. ICD-10.

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Volunteer Services

Orientation and Training. Recruitment. Retention. Cost Savings. Counting Hours for 5%.

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