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New Mexico Assoc. for Home & Hospice Care Annual Conference
November 8, 2018–November 9, 2018
Join Catherine Dehlin for her educational session.
Preparing for Hospice Probe and Educate
Toward the end of 2017, CMS shifted its medical review process from Progressive Corrective Action (PCA), to a Targeted Probe and Educate (TPE), designed to reduce and prevent improper payments, including payments to Certified Hospice Providers. Seeking to mitigate errors and teach, Medicare Administrative Contractors (MACs) are focusing TPE on targeted areas of performance (such as long length of stay). Performance metrics will identify providers who fall into the patterns of utilization aligned with focus areas. The provider’s metrics of performance will drive their likelihood of coming under review. Helping the provider to better understand TPE and prepare for its potential is the goal of this course. This course will review two main sections:
- The context for increased hospice provider scrutiny;
- The Hospice Targeted Probe and Educate (TPE);
- The MAC’s process of TPE and a providers’ optimal response;
- Current activity supported.
- The Key Performance Indicators (KPls) any hospice provider should regularly review to keep an eye on performance, looking through the lens of the MAC
- Organizational and Departmental Key Performance Behaviors (KPBs) to help drive the KPls into desired territory