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16-State Home Health and Hospice Coalition Met In Person with Palmetto GBA by Beth Foster Regulatory Affairs Director

16-State Home Health and Hospice Coalition Met In Person with Palmetto GBA by Beth Foster Regulatory Affairs Director

On Monday, June 24, 2019 sixteen states under Palmetto GBA’s jurisdiction met with Palmetto representatives to discuss Home Health and Hospice issues. Beth Foster, Regulatory Affairs Director, Kathy Royer, Hospice Regulatory Director, and Joe Russell, Executive Director from OCHCH were the only Ohio representatives in attendance. The following are key points discussed:

Hospice Targeted Probe and Educate (TPE):  Palmetto GBA has begun the process of Targeted Probe and Educate with Hospice providers. Currently 135 hospice providers from the Palmetto region will receive letters identifying the providers who will begin the first round of TPE. The focus area of the TPE audit is neuro NCLOS. You can review your level of risk by reviewing the electronic Comparative Billing Report (eCBR) which focuses on Non-Cancer Length of Stay (NCLOS) rates from October 1, 2018, to March 31, 2019. For your personalized Non-Cancer Length of Stay (NCLOS) eCBR results log on to eServices

HOME HEALTH and HOSPICE: Home Health and Hospice providers who have a HETS ID or get one, will lose access to the CWF eligibility queries this fall. Providers who do not have a HETS ID will not lose access to CWF eligibility queries. In addition, providers may have a concern when they log in DDE for CWF eligibility queries after the July 2019 System Release implementation and see a message about this. Detailed information can be found in the DDE User’s Guide information

Below are two CMS postings on this.


The Review Choice Demonstration (RCD) has just commenced implementation in Illinois as the home health agencies (HHAs) have selected their review choice option. A few Illinois HHAs have submitted documentation. At this time Palmetto is expecting a 7-10 day turn around for affirmations (or not affirmed), and then hope to decrease the turnaround to 3-4 days. The Illinois association is working with Palmetto GBA to decrease duplication of documents, asking for check boxes for codes, and requesting real time data.


The Palmetto GBA staff does not know what state is next, nor when will that state start!

Palmetto meets with CMS weekly and will be sharing the 16-State Coalition’s concerns.


SO, WHAT CAN OHIO’S HHAs DO NOW??? – Sign up for Palmetto’s eServices Portal NOW!

HHAs can only make their RCD option through the eServices Portal.

OCHCH will let you know as soon as we know when Ohio will be invited to the demonstration.

Beth Foster Regulatory Affairs Director