LeadingAge Calls for Simpler Hospice Notice of Election or Revocation

Legislation | August 28, 2017 | by Peter Notarstefano

Notices of election and revocation that Medicare requires hospice providers to file should be simplified and the process streamlined.

The hospice chosen by a Medicare beneficiary (or his or her representative) must file the Notice of Election (NOE) with its Medicare contractor within 5 calendar days after the effective date of the election statement. When the hospice election is ended due to revocation, the hospice must file a notice of termination/revocation of the election with its Medicare contractor within 5 calendar days after the effective date of the revocation, unless it has already filed a final claim for that beneficiary. If the hospice provider fails to submit a Notice of Revocation and the patient is admitted to a different hospice, the new hospice is held responsible for the other hospice’s error.

Due to the strict regulatory requirements for the submission of the notices of election and revocation, and the Medicare system’s difficulty in processing changes to patients’ Medicare benefits in a timely manner, hospice providers have cumulatively lost millions of dollars. The Centers for Medicare and Medicaid Services recently announced that hospice Notice of Elections can be filed electronically effective Jan. 1, 2018, which may reduce errors and improve the timeliness of submissions.

Related Statute/Regulation:

§ 418.24 Election of hospice care, § 418.28 Revoking the election of hospice care

Proposed Solution:

Former and current hospices should be simultaneously in the system until the Notice of Revocation is submitted, so the new hospice provider is not held accountable, and there is no delay in implementing hospice services.

Simplify the method of filing the Notice of Election to give providers immediate feedback on the submission of the notice and allow the hospice provider to correct any mistakes on the notice resulting from human error or a technical problem.