2021 Reminders: Top 3 Hospice Reports You Need to Submit on Time
We have officially said our goodbyes to 2020 and welcomed 2021 just a few days ago. The entire healthcare industry including hospices is hopeful but at the same time cautious about the opportunities and challenges this new year will bring. Despite the promising start of the new year however, compliance requirements, specifically hospice reports, are here to stay. As we enter the 1st half of 2021 when most reports are due, we’ll give you a rundown of the three reports you need to work on as early as now to avoid payment or license suspensions.
Hospice Cap Report
The Hospice Cap Report determines whether your agency has breached the annual aggregate cap which is equal to the cap amount multiplied by the number of Medicare beneficiaries you provided care to within the relevant cap year. For this year, the deadline for submission of your cap report to your Medicare Administrative Contractor (MAC) is on March 1, 2021 — five (5) months from the end of the cap year last September 30, 2020. Take note though that the 2020 cap report is due only for hospices which were certified on or prior October 1, 2019. For those certified after, your first cap report will be due by February 28, 2022.
To ensure that you can submit on or before the deadline, you need to access your Provider Statistical and Reimbursement (PS&R) to obtain your summary and hospice cap information. If you have no access yet, you should request for it now as it might take as long as two weeks to receive your credentials during this busy season. You will also need to make sure that cap amounts or rates are updated in your billing system for easier validation of your calculations. It is vital you submit your report on time as payments to your agency may be suspended until such time your self-determined hospice cap report is received by your MAC. To know more about the hospice cap report and what you can do to manage deadlines and overpayments, read here.
Hospice Cost Report
The Hospice Cost Report contains your agency’s financial, statistical, and descriptive data (e.g. patient census, revenues, expenses, etc.) and measures your allowable Medicare cost per day per level of hospice care. Deadline for submission of the cost report is five (5) months after the end of your fiscal year. If your fiscal year covers January 1, 2020 to December 31, 2020, then your hospice cost report is due this May 31, 2021.
Same with the cap report, you would need access to your PS&R to obtain and download data to prepare your cost report. Once prepared, you can choose between submitting it to your MAC via mail or via the Medicare Cost Report e-Filing (MCREF) portal which allows you to submit the form electronically. As with the hospice cap report, late filing of the cost report will result in your Medicare payments being put on hold until it has been reviewed and accepted by your MAC. As this might take around 30 days during peak season, it is strongly advised you file early. For more information on the submission process, you may read this article.
Hospice Annual Utilization Report
The hospice annual utilization report includes data on your agency’s patients, visits, services, utilization, revenues, and expenses. It is required by the State of California Office of Statewide Health Planning & Development (OSHPD) to be submitted every March 15th of the year or on the following working day if March 15 falls on a holiday or a weekend. The report usually covers the previous calendar year from January 1 to December 31. However, if there is a change in your agency’s ownership within the year, the previous licensee should submit a report covering the period from January 1 until the last licensure date while the current licensee should submit a report covering the effective licensure date until December 31. Otherwise, you may also request to submit a combined full year report as long as both the former and current licensees have agreed on who will be responsible for the submission.
Submission of the Annual Utilization Report can only be done through OSHPD’s System for Integrated Electronic Reporting and Auditing (SIERA) — an online report collection enterprise system. The OSHPD does not allow any other submission format unless prior written permission has been granted to your agency. You can submit, view, or revise annual utilization reports in the SIERA as well as view your license information. It is a must that you submit your annual utilization report on time as late filings can lead to your agency’s license being suspended.
Keeping track of all these deadlines this year may be challenging to do so on top of caring for your patients. This is when an intelligent Electronic Medical Record (EMR) system such as Data Soft Logic’s Hospice Centre can help you. With DSL’s compliance-augmenting features, workflow, and solutions, you can be assured your agency continues to deliver quality patient care while staying compliant with Medicare and state regulations. To know more about how we can help you, schedule a demo with us now.
