Regulatory Updates

State: All

Date Posted : 09/19/2024

Program: Hospice

CMS updated the Hospice Certifying Physician Enrollment Q&A document.  The most current version of this document is dated September 19, 2024.  Hospice providers are encouraged to review this document to ensure compliance with CMS requirements.

State: Florida

Date Effective : 10/1/2024

Program: Home Care, Private Duty

AHCA has released the finalized Medicaid Private Duty Nursing and Family Home Health Aide Services Coverage policy update.  Updates to the policy include terminology changes, eligibility & coverage requirements, documentation requirements, and reimbursement updates.

State: Texas

Program: Hospice

CMS has issued and MLN fact sheet related to expanded prepayment review and related activities for existing hospice providers in Arizona, California, Nevada, & Texas.

State: All

Program: Hospice

CMS has updated MLN Matters Number MM13531.  This MLN assists providers in understanding edits on hospice claims related to Hospice Certifying Physician Medicare Enrollment requirements.  Providers are also encouraged to review their MAC's websites as well for any additional instructions.

State: All

Date Effective : 10/1/2025

Program: Hospice

CMS has recently updated the CMS HOPE website with resources to help Hospice agencies prepare for implementation of the new HOPE assessment instrument which will be effective October, 1 2025.  These updated resources include the finalized HOPE manual, data that will be collected at the required time points, and an all-item set change table to help agencies educate staff on changes from the current HIS items set items to the new HOPE items.  Read more on the CMS HOPE website about these important changes that will be coming.

State: Louisiana

Date Effective : 09/12/2024

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

Pursuant to Section 1135(b) of the Social Security Act (the Act) (42 U.S.C. § 1320b-5), I, Xavier Becerra, Secretary of Health and Human Services, hereby waive or modify the following requirements of titles XVIII, XIX, and XXI of the Act and regulations thereunder, and the following requirements of Title XI of the Act, and regulations thereunder, insofar as they relate to Titles XVIII, XIX, and XXI of the Act, but in each case, only to the extent necessary, as determined by the Centers for Medicare & Medicaid Services, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the consequences of Hurricane Francine, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse