What are Benefit Enhancements (BEs)?

BEs are enhanced benefits to support high-value services and allow ACOs to more effectively manage the care of its Beneficiaries.

 

Collaborative Care Partners, LLC offers the following BEs to its attributed Traditional Medicare Beneficiaries and their providers.

 

For Medicare Beneficiaries:

• Three-Day Skilled Nursing Facility (SNF) Rule Waiver: Waives requirements for a 3 day inpatient stay before SNF admission (including long-term care facilities).

• Telehealth Expansion: Removes certain geographic restrictions for certain telehealth services and expands asynchronous telehealth geographically for dermatology and ophthalmology.

• Post-Discharge Home Visits: Allows nine home visits under the general supervision of a physician following an inpatient stay.

• Care Management Home Visits: Allows 20 care management home visits under the general supervision of a physician within a calendar year.

• Home Health Homebound Waiver: Waives the homebound requirement when a beneficiary has a combination of clinical risks, including two of more chronic illnesses along with criteria relate to inpatient utilization, frailty, and/or social isolation.

• Concurrent Care for Beneficiaries Who Elect Medicare Hospice: Allows the beneficiary to forgo curative care as a condition of electing the hospice benefit and instead receive care with respect to their terminal illness, allowing them to have hospice and curative care at the same time.

For questions or to inquire about BE eligibility, Beneficiaries should speak with their provider, or call the CCP line at 216-957-3001.

 

For Providers:

• Nurse Practitioner (NP) and Physician Assistant (PA) Services: Allows NPs and PAs to certify and order five types of care for beneficiaries, to the extent permitted under applicable state law:

  1. Hospice Care Certification

  2. Certification of Need for Diabetic Shoes

  3. Certification of Cardiac Rehabilitation Care Plan of Cardiac Rehabilitation

  4. Certification of Plan of Care for Home Infusion Therapy

  5. Referrals for Medical Nutrition Therapy

 

For questions or to inquire about BE criteria and eligibility, please call the CCP line at 216-957-3001.