Hospice Care for VNS Health Medicare Patients
VNS Health Medicare is one of a handful of designated CMS Innovation Center Model participants for the Hospice Benefit Carve-In, designed to increase patient access to hospice services, simplify payment by moving it from Medicare to the patient’s Medicare Advantage plan, and improve coordination between hospice providers and other clinicians at the patient’s end of life. For patients who are diagnosed with a terminal illness, VNS Health Medicare will offer the Hospice Benefit until the end of the model test on December 31, 2024.
What this means is that patients that elect hospice on or before December 31st will be managed by VNS Health Medicare and any elections made starting on January 1st, 2025 will be managed by traditional Medicare Fee-for-Service.
Important Notice: Changes to Hospice Benefit Effective January 1, 2025
For Providers
- Starting January 1, 2025, VNS Health Health Plans will no longer manage the hospice benefit for Medicare members.
- All hospice providers must send claims and Notices of Election (NOE) directly to Medicare for patients that elect hospice on or after January 1, 2025.
- Information about in-network hospice providers will be removed from our website as of January 1, 2025.
- Note: Any patient that elects hospice on or before December 31, 2024, will still be managed by our health plan until the patient is discharged, which may occur in 2025. Any elections beginning January 1, 2025, will be handled by Medicare
Claims must be submitted to both VNS Health Medicare and to the Centers for Medicare and Medicaid Services (CMS) for care provided to patients that elect hospice on or before December 31, 2024.
- Beginning on January 1, 2025, Providers should send all claims, NOA, and NOTR to Medicare only.
- Detailed billing instructions and NOA submission guidelines can be found on the Medicare website
Please note: For patients that elect hospice on or before December 31, 2024, hospice providers are required to submit a Notice of Election (NOE) to us and CMS within 5 days of hospice election and Notice of Termination/Revocation (NOTR) within 5 days of hospice termination. Please submit all Hospice NOE and NOTR material to [email protected] for elections made on or before December 31, 2024..
Or you can mail your Notice of Election to:
VNS Health
Health Plans – Membership Eligibility Unit
220 East 42nd Street
New York, NY 10017
Notices of hospice elections beginning on or after January 1, 2025 must be submitted directly to Medicare only.
- Hospice-related inquiries for patients that elect hospice on or after January 1, 2025 should be directed to Medicare.
- Contact information for Medicare can be found on the Medicare website or by calling 1-800-MEDICARE
Hospice-related inquiries for patients that elect hospice prior December 31, 2024 should be directed to The VNS Health contacts as follows:
Hospice Network Administrative Contact:
James Biebel
[email protected]
646-477-1898
Clinical and Patient Support Contact:
Esther Conteh
[email protected]
212-609-1898
- Patients that elect hospice with TCC on or before 12/31/24 can continue to receive the services up to the 60-day period. Under the TCC benefit, patients who elect hospice care with an in-network hospice provider can choose to maintain their usual curative care for up to 60 days from the date of hospice election.
- TCC services will no longer be managed by VNS Health for elections on or after January 1, 2025.
- Although VNS Health will no longer manage the hospice benefit, we encourage providers to refer eligible members to
- If you are a physician who ordinarily provides primary or specialty care services to a patient who is now in hospice, you should bill us directly. You do not need to bill both CMS and VNS Health Medicare, unless you are specifically a hospice provider or facility.
For Members
- Starting January 1, 2025, VNS Health Health Plans will no longer manage the hospice benefit for Medicare members.
- Hospice will be managed directly by traditional Medicare, which will handle all hospice-related questions.
- Note: Any patient that elects hospice prior to December 31, 2024, will still be managed by our health plan. Any elections beginning January 1, 2025, will be handled by Medicare.
- For any hospice-related questions, you should contact Medicare. You can find contact information on the Medicare website or by calling 1-800-MEDICARE.
- Starting January 1, 2025, information about in-network hospice providers will be removed from our website.
- Hospice providers will be managed directly by Medicare. You can check the Medicare website for information on available hospice providers.
- Patients that elect hospice with TCC on or before 12/31/24 can continue to receive the services up to the 60-day period. Under the TCC benefit, patients who elect hospice care with an in-network hospice provider can choose to maintain their usual curative care for up to 60 days from the date of hospice election.
- TCC services will no longer be managed by VNS Health for patients that choose hospice on or after January 1, 2025.
- Yes, you can choose VNS Health Hospice for your hospice care. VNS Health Hospice is dedicated to providing high-quality, compassionate care. VNS Health Hospice Care. For more information or to refer a VNS Health Medicare patient, call 212-609-1920.
- Yes, our health plan will continue to offer palliative care services to eligible members. Palliative care is an important part of our care model, and we remain committed to providing these services to support our members’ quality of life.