NHPCO members receive fraudulent invoices

The National Hospice and Palliative Care Organization (NHPCO), Alexandria, VA, has issued an alert warning members that fraudulent NHPCO membership dues invoices have been faxed to some members.

The faxed dues invoice was from an organization called the National Home Care and Hospice Palliative Care Association for 2010 annual dues of $475. The payment address has a Massachusetts address. These faxed invoices are similar to ones sent to hospice providers in fall 2009.

NHPCO's alert states that the organization does not fax renewal notices. The NHPCO renewal notices were mailed to members in fall 2009. NHPCO is investigating the source of the faxes. Any NHPCO member with questions about an invoice should contact NHPCO by phone at (800) 646-6460 or e-mail MemberService@nhpco.org.

Payment fact sheet available from CMS

The revised Hospice Payment System Fact Sheet is available in print format from the Centers for Medicare & Medicaid Services' (CMS) Medicare Learning Network.

The free fact sheet provides general information about the Medicare hospice benefit including coverage of hospice services, certification requirements, election periods, how payment rates are set, patient coinsurance payments, caps on hospice payments, and additional reporting required on hospice claims.

To place your order, login and visit www.cms.hhs.gov/MLNGenInfo, scroll down to "Related Links Inside CMS" and select "MLN Product Ordering Page." Scroll down to "Medicare Payment Policy" and select "Hospice Payment System Fact Sheet (ICN# 6817)(Nov 2009) (Fact Sheet)."

NHPCO objects to MedPAC projections

The National Hospice and Palliative Care Organization (NHPCO) urged the Medicare Payment Advisory Commission (MedPAC) to adjust the community's 2010 projected profit margins from 4.6% to 2.6% to more accurately reflect hospice's unique, mandatory program costs of volunteer and bereavement services.

The hospice benefit includes all care related to the terminal illness and requires programs to provide up to 13 months of bereavement services to the families and loved ones of the beneficiary after he or she dies. In addition, the Medicare hospice benefit requires that trained volunteers provide at least 5% of the patient care hours. These services are mandatory as detailed in the hospice conditions of participation, and these requirements are unique to the hospice benefit.

"While other providers also may establish volunteer programs, and perhaps the cost of those programs are considered nonreimbursable costs on the Medicare cost report, we know of no other provider that is federally required to establish and maintain a volunteer program and to track and document the cost savings achieved," says NHPCO vice president of public policy Jonathan Keyserling, JD. "The costs of both volunteer and bereavement services must be included in the margin computation. Any other approach would ignore the financial reality of hospice programs bearing these mandatory costs."

MedPAC staff projected hospice margins of 4.6% for 2010. NHPCO contends this figure overstates the actual margin being experienced by most hospice programs. "The MedPAC staff previously noted that they estimated bereavement costs to be about 1.5%. Another cost for every hospice program is the cost of administering and tracking volunteer services, but these also are not considered in margin calculations. We estimate that the cost of volunteer services would be 0.5%. Therefore, the "true" margins of hospice programs, providing the range of required services under Medicare, would then be 4.6% minus 1.5% minus 0.5%, yielding a real margin of 2.6%," says Keyserling.

The 2008 MedPAC projection for hospice margins was 3.4%. NHPCO argues that a 4.6% projection for 2010 indicates, mistakenly, that hospice margins are growing, adds Keyserling.