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April 10, 2018

Reminder: Submitting Hospice Exceptions for Untimely Notices of Election (NOE)

When the receipt date on your NOE is more than 5 days after the admit date, your NOE is considered to be untimely.  This means that those days, from admission to the day before the NOE was received, are not payable by Medicare.  Hospices may file an exception request if the following exceptions apply. 

  • Fires, flood, earthquakes, or other unusual events that inflict extensive damage to hospice’s ability to operate
  • An event that produces a data filing problem due to CMS or contractor system issues, beyond the control of the hospice
  • Newly Medicare-certified hospice that is notified of certification after Medicare certification ate, or awaiting user ID from Medicare contractor; or
  • Other circumstances determined by the Medicare contractor or CMS to be beyond hospice’s control.

Documentation for Exception Requests
Providers must provide sufficient information in the REMARKS field (FISS Page 04) that clearly indicates all the circumstances and time frames supporting the exception request. If the information in the REMARKS field is not clear, CGS will request additional documentation. If requested, send any documentation that supports the reason why the NOE was untimely.

In cases where the NOE could not process because a prior hospice benefit period had not been terminated, submit a dated screenprint of the beneficiary's eligibility record showing the open benefit period. In addition, any documentation to support your contact with, or attempts to contact, the prior hospice may also support the exceptional circumstance. In these cases, your documentation must show that the NOE was submitted timely, and subsequently RTPd or rejected because of the open hospice benefit period. If, upon review, CGS determines that the NOE was not initially submitted timely, the exception may not be granted.


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