Regulatory Updates

State: All

Hospice – Free Medicare Hospice YouTube Video

Date Posted : 11/3/2022

Program: Hospice

National Government Services (NGS) has an array of educational Medicare Hospice YouTube videos regarding billing and documentation. These videos are free, short in length and very informative. They contain information on the required elements of the hospice notice of election statement (NOE) and how to correct a date on the hospice NOE. Please share these links with your clinical and billing staff as appropriate:

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State: All

DMEPOS enrollment transition

Date Effective : 11/7/2022

Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Pharmacy

National Supplier Clearing House is transitioning to:

1. National Provider Enrollment West - Western Region awarded to Palmetto GBA
2. National Provider Enrollment East - Eastern Region awarded to Novitas Solutions

Important Information Regarding Upcoming Changes to the DMEPOS Enrollment Contractor: Nov. 6, 2022, is the last day that the National Supplier Clearinghouse (NSC) will process Medicare enrollment applications for DMEPOS suppliers. Effective Nov. 7, 2022, two new contractors will process all DMEPOS enrollment applications:

• Novitas Solutions: Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands
• Palmetto GBA: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands

CMS-855S application The Provider Enrollment, Chain, and Ownership System (PECOS) is the best option to complete and submit your enrollment applications. PECOS supports the Medicare supplier enrollment process by allowing registered users to securely submit and manage Medicare enrollment information online. If you utilize paper applications, continue to use the current CMS-855S form found on our website; however, disregard the address listed on page 4 of the application advising to send the application to the National Supplier Clearinghouse (NSC). We will notify you via our eNews email when the new form is available, how to access it, and the updated address to submit your CMS-855S applications. What happens to my application upon transition? If you are within the eastern state region for DMEPOS, your existing enrollment record will be transferred to Novitas in PECOS. If you are within western state region for DMEPOS, your existing enrollment record will be transferred to Palmetto GBA in PECOS. On November 7, any application still in progress or under review will be transferred from the NSC to Novitas Solutions and Palmetto GBA and receive a new document control number (DCN). A Novitas/Palmetto representative will communicate your new DCN by calling or emailing the contact person listed on the application. There is no action required from you!

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State: All

No Surprises Act: Fact Sheets for Your Patients

Date Posted : 07/1/2021

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Home Health, Home Infusion Therapy, Hospice, Renal Dialysis

Share information with your patients to help protect them from surprise billing. As of January 1, 2022, they have new billing protections when they get:

• Emergency care
• Non-emergency care from out-of-network providers at in-network facilities
• Air ambulance services from out-of-network providers

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State: Texas

Texas – Licensing Requirements for In-home Supportive Palliative Care

Date Adopted : 09/15/2021

Program: Home Health, Hospice, Private Duty

The legislation created Texas Health and Safety Code (HSC) Chapter 142A (relating to Supportive Palliative Care), establishing a definition of "supportive palliative care" and indicating that any reference to "palliative care" in law or the Texas Administrative Code (TAC) means supportive palliative care. The statute did not establish a category of licensure for the provision of supportive palliative care services—either standalone or as a category within an existing care delivery setting. Supportive palliative care services that are delivered in the home or in community settings, such as in assisted living facilities, are currently governed by HSC Chapter 142 (relating to Home and Community Support Services Agencies (HCSSA)). An HCSSA license is required.

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State: All

Update to ‘J’ Drug Code List for Billing Home Infusion Therapy (HIT) Services

Date Posted : 06/9/2022

Date Effective : 07/1/2022

Program: Home Infusion Therapy

CR 12667 updates the list of home infusion drugs to add J1551 JB (Injection, immune globulin (cutaquig), 100mg) to payment category 2, effective July 1, 2022. The corresponding G-codes for category 2 drugs are G0069 or G0089. Note: We require the JB modifier for subcutaneous injection of the drug.

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State: All

DMEPOS Accreditation mln Fact Sheet Updated in January 2022

Date Posted : 01/1/2022

Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Pharmacy

This fact sheet describes Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers’ accreditation requirements. This includes verifying your business meets the required DMEPOS quality standards, types of eligible professionals exempted from accreditation, updating your enrollment information, and resources. This information applies to all DMEPOS suppliers submitting claims to Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for Medicare patients’ DMEPOS items and supplies.

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