If you are a physician who ordinarily provides primary or specialty care services to a patient who is now in hospice, you should bill CHOICE directly. You do not need to bill both CMS and CHOICE, unless you are specifically a hospice provider or facility. 

Designation under the CMS Innovation Center Model means CHOICE Total, as a participating Medicare Advantage Organization (MAO) is responsible for coverage and payment of all services covered by Original Medicare, including hospice.  These changes only apply to patients who elect to begin hospice care, receive that care from CHOICE Total and are enrolled in the plan in 2021.

The hospice carve-in is intended to increase access to hospice services and facilitate better coordination between patients’ hospice providers and their other clinicians. The Hospice Benefit Component of the Value Based Insurance Design (VBID) Model is an opportunity for CHOICE Total and hospice providers to collaborate and improve care coordination, transparency, and quality.

Hospice services for qualifying members begin on January 1, 2021.

These services will be offered in the Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk, and Westchester Counties.

Claims must be submitted to both CHOICE Total and to the Centers for Medicare and Medicaid Services (CMS). We will be sending you more information about submitting hospice notices and claims.

You may also view up-to-date information on the Model’s website.

• Hospice Network Administrative Contact:
  John Caralyus 
  john.caralyus@vnsny.org
  646-300-2898
• Clinical and Patient Support Contact:
  Esther Conteh
  esther.conteh@vnsny.org
  212-609-1898