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Under CMS Change Request 8877, hospices must submit an NOE for a patient within five days of that patients Medicare admission. There are four exceptions that Medicare allows hospice to use to appeal a late filing penalty. CGS has posted examples of granted and denied Notice of Election (NOE) exemptions requests in order to clarify when hospices should appeal claims.  

The four circumstances that may qualify a hospice for an exemption to the consequences of filing a late NOE are: 

  1. Fires, floods, earthquakes, or other unusual events that inflict extensive damage to the hospice’s ability to operate;
  2. An event that produces a data filing problem due to a CMS or Medicare contractor systems issue that is beyond the control of the hospice;
  3. A newly Medicare-certified hospice that is notified of that certification after the Medicare certification date, or which is awaiting its user ID from its Medicare contractor; or,
  4. Other circumstances determined by the Medicare contractor or CMS to be beyond the control of the hospice.

In general, the CGS examples show that if the reason NOE was untimely is beyond the hospices control, the exemption will be granted. Review the CGS examples here

Looking for more articles on filing exemption requests for untimely NOEs? Check out these articles: