ExpiredHospice Administrators

  • August 21, 2020
    2:30 pm - 5:00 pm
  • September 18, 2020
    2:30 pm - 5:00 pm

Notes from August Call

We talked about upcoming hospice education events that the Alliance will be hosting, including the Annual Hospice Volunteer Education event in October on three Wed. mornings, The Fall Hospice & Palliative Care Conference on November 18th & 19th and a series of events in the fall to bring together hospice administrators and long term care administrators. All events are being held virtually for the first time this year.  Look for details in The Alliance Insider and on the Alliance website.


Also – In case you didn’t see it yet – the Alliance is offering a webinar on Monday, August 31st detailing the Hospice Election Statement changes and addendum requirement that will go into effect October 2020.

You can register by going to this link https://homecarenh.org/wp-content/uploads/events/new-hospice-election-addendum-requirements/#tkt-slctr-tbl-27656


The remainder of the meeting was a round table discussion on providing care in long term care facilities and the required COVID testing. It was a lively discussion about the different methods and sources being utilized for testing as well as the cost to agencies and lag time in getting test results. This conversation again highlighted the differences in process between facilities and the lack of funding for the tests which vary from weekly to bi-weekly.  It was also mentioned that assisted living facilities and some long term care skilled facilities request designated hospice staff.


The conversation moved to concerns about the NOE and required addendum going into effect in October. Questions were raised about the possible changes to the care plan after the admission and how to document what is related or unrelated as the patient’s needs change.  Also discussion about the ethical issues of “just pay for everything”.


Our next call will be on Friday, Sept. 18th. Please let me know if there are topics that you would like to discuss.



Janice McDermott

Director of Hospice & Palliative Care

Home Care, Hospice & Palliative Care Alliance of NH


My Updates for you are:

  1. On Friday, July 31, the Federal Register posted the FY2021 Hospice Wage Index and Payment Rate Update Final Rule on the public inspection page. It is scheduled to publish in the Federal Register on August 4, 2020. (full document is attached)

Key elements of the final rule include:

  • Rate increase of 2.4% for FY 2021, effective October 1, 2020. Note that this is slightly lower than the rate increase of 2.6% in the proposed rule.
  • Adjustments in CBSA designations, following the guidance published by OMB in 2018. This may result in higher or lower wage index values, based on the new designation including changes in CBSA numbers on the FY2021 State/County Rate beginning October 1, 2020.   There is no change in designated territories for New Hampshire.
  • Counties with a decrease in the wage index values will have a maximum of 5% reduction for FY 2021 but will see the full reduction in FY 2022.
  • There will be NO delay in the implementation of the changes to the election statement and addition of the election statement addendum. These new requirements will be effective for hospice admissions on or after October 1, 2020.
  • A model election statement and addendum were provided by CMS.  (See attached documents)
  • CMS provided some details about the election statement and addendum implementation but are expected to release clarifications by Oct. 1.


  1. NGS announced that all TPEs (Target, Probe & Educate) are on hold indefinitely, but they will be starting ADR audits in the next couple of weeks.  These will be done by random selection of hospice claims with a length of stay greater than 730 days. This will be a small sample in our multistate region but if your agency is drawn, they can ask for a maximum of 20 claims to review.  They also announced that they would make personal phone calls to agencies selected to let them know that the ADRs are coming and answer questions.
  2. The Hospice Volunteer Education day will be a virtual event this year held on three consecutive Wed. mornings in October.  This will be in a zoom format. We have an amazing planning committee comprised of your volunteer managers and the program is something that everyone is excited about. We have hired an amazing author, Susan Turnbull to provide one of the sessions on creating Ethical Wills and legacies.  Since this is a virtual event, we will not have to limit the number of volunteers who attend.  We will keep the flat rate registration fee based on the volume of active volunteers in your programs.  Look for the details and registration link in the next couple of weeks and please support you Hospice Volunteers by continuing to participate.
  3. Jean Acevedo and her son Chris will be providing webinars hosted by the Alliance on Palliative Care Billing later this year.  Jean and Chris are the national experts on this. Dates and details to follow.


NHPCO submitted comments on the FY 2021 Hospice Wage Index and Payment Update Proposed Rule on June 9, 2020.  Highlights from the NHPCO recommendations include:

  • Support for the 2.6% market basket increase for FY 2021
  • Support for the 5% limit for a one-year transition when a Core-Based Statistical Area (CBSA) wage index decreases.
  • Delay the implementation of the election statement and addendum for at least one full year beyond the end of the COVID-19 public health emergency (PHE).
  • Request additional clarification on patient death before the five day time frame to issue the addendum, who can request an addendum, and what steps to take when a patient or representative refuses to sign the addendum.
  • Clarify the relationship between the addendum and the Advance Beneficiary Notice (ABN).
  • Allow an electronic format for the election statement and addendum and provide guidance on electronic signatures for beneficiaries and representatives.
  • Object to the addendum being identified as a condition of payment.
  • Detailed recommendations on changes to both the election statement and the proposed addendum examples


No comments yet.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.