Have you read the report from the Department of Health and Human Services? Medicare Part D reimbursements for hospices are likely to be scrutinized more carefully in the near future.
The report, which was released in August, determined that Medicare Part D paid for $160.8 million of drugs that should have been paid for by hospice programs. The details of the report come from an audit by the Office of Inspector General (OIG) which examined $422.7 million in Part D costs in 2016 for prescriptions filled for beneficiaries in hospice. The OIG called on the Centers for Medicare & Medicaid Services (CMS) to do better and ensure they’re not paying twice for the same drugs, as hospice coverage includes drug costs.
Moving forward, hospices will need to make sure they are in full compliance, and appropriately reimbursed by the CMS. Our partners can rest assured knowing that their medication reimbursement is in full compliance with Medicare requirements.
With 30 years of dedication to hospice, we pride ourselves on being the hospice industry’s most innovative, flexible and comprehensive dispensing pharmacy and PBM provider.
Here's how we help you ensure compliance.
Risk assessment reports:
Our risk assessment report and analysis identifies those non-covered medications (as determined by the hospice) where the hospice has the greatest CMS compliance exposure. This is determined by assessing and comparing each patient’s medication profile to the coverage expectations set out in both the CMS annual Hospice Wage Index reports as well as any reporting from the Office of Inspector General.
Patient inactivity reports:
Patient inactivity reports are one of the ways that we help hospices stay billing compliant. If patients are listed as active, but their medications have not been processed in the past 30 days, they will appear in a patient inactivity report. Using these reports, hospice and its PBM can determine if third party pharmacies are billing properly and can identify if a patient needs to be discharged.
Patient face sheets:
We fax patient face sheets and complete medication lists to long term care pharmacies to ensure billing accuracy. These patient face sheets and medication lists detail a patient’s covered medications, non-covered medications and OnePoint Patient Care’s proper billing practices.
We specialize in hospice pharmacy so you can specialize in patient care.
Our goal is to minimize any distraction from your clinical team’s primary purpose…patient care.
OnePoint Patient Care is the original hospice pharmacy partner capable of aggregating patient medication orders, dispensing and consolidating prescriptions into one delivery tote, and coordinating successful, timely delivery to the patient. And, with our ability to handle both dispensing and PBM, we’re able to help hospices not only stay in compliance but also boost efficiency and optimize cost management.
There’s a reason why our 99% partner retention rate is the highest in the industry. We know that hospice is “high touch” care, and we believe hospice pharmacy should be a “high touch” partnership.