The new Hospice Item Set (HIS), effective in April 2017, left a confusing piece – Item 1400, regarding the patient’s payer information at time of admission–for hospices to ponder. The National Association of Home Care & Hospice (NAHC) stated in a June 9 statement that the association has been fielding “numerous questions” regarding the item. As a result, NAHC submitted questions to CMS and received clarifying guidance.
The guidance NAHC recieved stated that regardless of the likelihood that a patient’s payer will ultimately be the entity that provides reimbursement, it should be listed in A1400, along with any other potential patient payer. According to NAHC, A1400 reflects “all payors available for healthcare expenses.”
Note that healthcare expenses includes services as well as medications, supplies, and room and board.
More information about classifying payers is available at the NAHC site. Note that to classify individual commercial plans, CMS recommends providers use their best judgement. For state or other government plans, CMS recommends following-up with appropriate government contacts to better classify these plans.