West Deptford, NJ (PRWEB) January 13, 2014
On July 26, 2013, the Department of Health & Human Services (DHHS) and the Centers for Medicare & Medicaid Services (CMS) published their Change Request 8358 to the Hospice Industry regarding additional data reporting requirements for hospice claims. Enclara Health, a comprehensive mail order provider, as well as a pharmacy network manager for its hospice customers, is prepared to support their clients with these new regulations. Enclara will be providing the line item detail, as specified by CMS. The information will be supplied in a secure format, with the ability to run by specific date ranges.
Voluntary reporting of these additional elements commenced on January 1, 2014, with mandatory submission going into effect on April 1, 2014.
Specific requirements for prescription medications include (provided by CMS Manual System, DHHS/ CMS: July 26, 2013):
- 0250 Non-injectable Prescription Drugs:
Required detail: Report on a line-item basis per fill, using revenue code 0250 and the National Drug Code (NDC). The NDC qualifier represents the quantity of the drug filled and should be reported as the unit measure.
- 0636 Injectable Drugs (Applicable HCPCS):
Required detail: Report on a line item basis per fill with units representing the amount filled. (i.e. Q1234 Drug 100mg and the fill was for 200mg, units reported = 2).
The additional data reporting was promulgated by the Affordable Care Act of 2010, section 3132(a) and will include reporting of general inpatient care visits, the facility NPI where care was provided when not provided at the billing hospice facility, and reporting of infusion pumps and prescription drugs.
“The regulatory and reporting landscape is changing for the hospice industry. As we have previously, our goal is to respond swiftly to our customer’s needs and we are responding by enhancing our robust technology platform and programming capabilities,” states Betsy Rothley, Chief Development Officer for Enclara.
Enclara Pharmacia services over 300 hospice locations and over 23,000 hospice patients daily throughout 46 states.