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IMPORTANT HOSPICE UPDATE: Issues with Electronic Submission of Hospice NOEs

Posted on Monday, January 8, 2018 1:41 PM

“In July 2017, the Centers for Medicare & Medicaid Services (CMS) issued Change Request 10064Accepting Hospice Notices of Election via Electronic Data Interchange, providing instruction on submission of hospice Notices of Election (NOEs) electronically, which was effective January 1, 2018.  Details related to the development of software that would allow for submission of NOEs and related transactions through Electronic Data Interchange (EDI) were appended to CR10064 as Attachment 1(Companion Guide).  Over recent months the Medicare Administrative Contractors (MACs) and hospice software vendors have been working to implement the changes that will allow for electronic processing of NOEs and similar transactions.”

The past two days have shown that there are two issues having an impact on accepting/processing of electronically submitted NOEs.  The first issue that has been discovered is that the Companion Guide that was issued last summer left off detail related to a data element that must be provided as a part of an electronically submitted NOE to avoid front end rejection. 

The second issue is “NOEs go through a number of edits at different points as they process through the MAC and CMS systems.  The MACs have discovered that at an advanced point in processing electronic NOEs are being returned to provider with the edit E2101 (Patient Status Code Omitted or Code Impossible).  A systems fix to address this problem has been scheduled for implementation on February 5, 2018, but in the meantime, EACH MAC IS ADDRESSING THIS ISSUE IN A DIFFERENT WAY, so hospices are urged to monitor communications from their assigned MAC for details and updates on how to proceed.  Following are status updates provided yesterday by CMS on how the various MACs are approaching processing of electronic NOEs in light of the existing systems issue:

CGSGiven the edit within the CWF that is ultimately returning to provider electronically submitted NOEs, CGS has notified providers to submit via DDE for now.  CGS is testing a workaround that could allow for electronic submission in the near future, but that is unclear at this time. Please watch the CGS website and updates for the latest developments.

NGSNGS has NOT notified providers to hold off EDI submissions and does not plan to, because NGS has instituted a manual workaround that is being used to allow electronic NOEs to process through. So, once a hospice has ensured that the software they are using includes the description that should accompany Q5009 (ISSUE ONE, referenced above), they may submit electronically and should not be affected by the CWF edit.

Palmetto GBA — Palmetto has notified providers to submit via DDE for the time being. At this time it is not anticipated that this will change prior to a systems fix that is scheduled for February 5.  However – again – providers should watch for updates from Palmetto on this issue.”

Source: NAHC Report


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