HOSPICE- Staying out of the Special Focus Program

Overview:

This session will ensure that you have full understanding of how to ensure your agency stays off the radar of the Hospice Special Focus Program (SFP). Centers for Medicare & Medicaid Services (CMS) has created a “Special Focus Program” to identify poor performing hospices and help them improve through more frequent surveys and technical assistance. Did you know the SFP actually began January 1, 2024?? Your hospice data TODAY is counting towards the SFP. CMS will also impose enforcement remedies and fines to further incentivize improvement. In this presentation, Annette will discuss the Hospice Special Focus Program and work through the algorithm on what is considered, and how these are weighted- and may land hospices in this “special” program, and steps to ensure you don’t end up in that exclusive community.

Presenter: Annette Lee, RN, MS, HCS-D, COS-C

Annette is a registered nurse, with a Master’s in Health Care Administration, practicing since 1990.  For over a decade she worked with the CMS Home Health and Hospice intermediary, Cahaba GBA and CGS, where she provided review of, and education on home health and hospice documentation.  She worked as a specialist in the Medical Review, Appeals, and Provider Education departments, and assisted with cross-MAC quality assurance and training.

Annette then founded Provider Insights, Inc. providing consultative support and provider education regarding Medicare reimbursement issues and effective documentation strategies, assisting providers across the nation with Survey Preparation, ADRs and appeals. Today she continues to marry together her experience in the “real world” and the inside knowledge of Medicare to ensure providers can meet the requirements of CMS, and ensure compliant, efficient operations.