02/27/2019

Self-Determined Hospice Cap Calculation Deadline

Palmetto GBA announced on Thursday, February 21 they had only received about 1/3 of all the hospice Cap reports in their jurisdiction and are concerned if the Cap reports are not submitted to them by February 28, payments to hospice programs who have not submitted their Cap reports will be suspended beginning March 7.  Please see the following information from the Palmetto website if you have not submitted your Cap form:

Submitting the Self-Determined Cap Calculation:

What to send?

• Send only the completed and signed form (no other documentation)

When to send?

• The 2018 Provider Self-Determined Aggregate Cap Limitation is due on February 28, 2019
• If the completed form is not filed on time, a past due letter will be sent within seven (7) days and payments will be suspended
• If unable to file the form on time, a written request can be submitted prior to the due date to request a 50 percent payment suspension
• If an overpayment is computed and the amount due is not submitted, payments will be withheld

How to send?

• The form can be sent by email or mail. Email is the preferred method and offers the quickest acknowledgment receipt. (Only send by one method!)

Email to: HospiceCap@palmettogba.com. (Reference only your Provider Number in the subject line)

Mail to:

U.S. Postal Service Palmetto GBA Attn: Hospice Cap Reporting  Mail Code: AG-330 PO Box 100144 Columbia, SC 29202-3144

Courier Service  Palmetto GBA Attn: Hospice Cap Reporting  Mail Code: AG-330 2300 Springdale Drive, Building One Camden, SC 29020-1728

Repaying an Overpayment (if applicable)
If the cap computation indicates an amount due the Medicare Program, please submit a check made payable to Palmetto GBA for the full amount (or the first month payment if requesting and ERS) and mail the check to either of the following addresses. The payment can also be submitted using eCheck. eCheck is a feature of the eServices portal, where one can submit payments electronically. To register for and utilize this feature, access our website and select the eServices link.

U.S. Postal Service Palmetto GBA JM HHH Overpayments  Mail Code: AG-260 PO Box 100277 Columbia, SC 29202-3277

Courier Service  Palmetto GBA JM HHH Overpayments  Mail Code: AG-260 2300 Springdale Drive, Building One Camden, SC 29020-1728

Requesting an Extended Repayment Schedule 
If you are unable to repay the cap overpayment, you may submit documentation supporting a request for extended repayment. This documentation must be sent at the time of the submission of your cap computation to avoid withholding of your payments. The required documentation includes, but is not limited to, balance sheets, income statements, cash flow statements, and statements of source and application funds. 

A copy of the check sent in as the first payment of the proposed repayment schedule must be included with the documentation. To obtain the Request for Extended Repayment Plan form and instructions, please access the Forms section of the Palmetto GBA website.

Provider_Self-Determined_Aggregate_Cap_Limitation.xlsx (XLSX, 35 KB)
Instructions_for_Pro_Forma_for_Provider_Self_Determined_Aggregate_Cap_Limitation_2018.pdf (PDF, 37 KB)