Hospice Eligibility and Certification – The Continuing Saga

Hospices are undergoing increased regulatory scrutiny from CMS through Medicare Administrative Contractors (MACs), the OIG, Zone Program Integrity Contractors (ZPICs) and eventually Recovery Audit Contractors (RACs). Certifications are a condition of payment. It is critical that hospices understand the regulatory requirements of certification and recertification and to have a process that ensures doing it right the first time. There is no room for error. This session will explore the regulatory requirements related to the certification and recertification process including the face-to-face encounter requirement.  We will explore what types of documentation of eligibility is required for the certification and recertification process.  The presentation will include the examples of supporting clinical documentation that should be present at certification and/or recertification.