VBID Model Hospice Benefit Component Participating Plans

VBID Model Hospice Benefit Component Quick Links:

Overview  |  Coverage  |  Participating Plans  |  Billing & Payment  |  Outreach & Education  |  FAQs

Under the Value-Based Insurance Design (VBID) Model, in Calendar Year (CY) 2022, thirteen Medicare Advantage Organizations (MAOs) will participate in the Hospice Benefit Component, offering 115 plan benefit packages (PBPs).

Note:

A downloadable list of PBPs with service area and comprehensive contact information can be found here.

 

Highlighted Contacts for MAOs Participating in the Hospice Benefit Component in CY 2022

 

  • Anthem Inc. with plans in select counties in PR
    • Primary: Myra Plumey Rivera, (e): myra.plumey@mmmhc.com ; (p): 787-379-3327
    • Secondary: Marieva Hiraldo Espada; (e): marieva.hiraldo@mmmhc.com ; (p): 787-223-1672
  • AvMed with plans in select counties in FL
    • Hospice Network Administrative Contact: Joseph Young, Director, Hospital and Ancillary Contracting; (e): joseph.young@avmed.org; (p): 305-671-5437, ext. 27300
  • Cambia Health Solutions with plans in select counties in OR, UT, and WA
  • Catholic Health Care Systems (ArchCare) with plans in select counties in NY
    • Hospice Network Administrative Contact: Victor Fama; (e): vfama@archcare.org; (p): 646-584-7984
  • CVS with plans in select counties in OH and PA
    • Hospice Network Administrative Contact: Sara Rose Mollitor; (e): MollitorS@aetna.com; (p): 202-559-8234
  • Hawaii Medical Service Association with plans in select counties in HI
  • Humana Inc. with plans in select counties in CO, GA, IN, KY, OH, VA, and WI
  • Intermountain Health Care, Inc. with plans in select counties in ID and UT
    • Primary: Chris Engh Secondary: Russell Gardner
    • Primary (e): chris.engh@selecthealth.org Secondary (e): Russell.gardner@selecthealth.org;
    • Primary (p): 801-442-9075; Secondary (p): 801-442-7282
  • Kaiser Foundation Health Plan, Inc. with plans in select counties in CA
    • There are two steps to submit notices and claims for Kaiser Permanente Senior Advantage Ventura County Plan (H0524-034) members:
      • Send the Notice of Election to KP-NOE@kp.organd 
      • Submit claims via the Electronic Data Interchange (EDI) process. To sign up for EDI, please contact your clearinghouse and provide the appropriate payer ID.
    • Where do you get more information for Kaiser Foundation Health Plans, Inc?
      • For questions regarding member benefits and/or eligibility, please call Kaiser Permanente Member Services at 1-800-443-0815.
      • For regarding claims payment, please call Kaiser Permanente Claims Services at 1-800-390-3510
    • For all other questions regarding hospice:
  • Presbyterian Healthcare Services (PHS) with plans in select counties in NM
  • Triple-S Management Corporation with plans in select counties in PR
    • Primary: Myra M. Velez Plumey, (e): myra.velez@ssspr.com; (p): 787-749-4949 ext. 832-6354
    • Secondary: Provider’s Call Center: 1-855-886-7474
  • UnitedHealth Group with plans in select counties in AL, IL, OK, and TX
    • UHC Hospice Network Administrative Contact
      • Primary: Jennifer R. Smith; (e): hospicevbid@uhc.com; (p): 952-931-4041
      • Website: UHCprovider.com/mahospice
    • Clinical – Provider/Patient Support Contact (Alabama, Illinois, Oklahoma)
      • Primary: Mindy Stewart-Coffee
      • Patient/Pre-Hospice Consult (p): 833-753-2970
      • Provider Clinical Inquiries (Transitional Concurrent Care) (p): 833-753-2970
    • Clinical – Provider/Patient Support Contact (Texas)
      • Primary: Tracey Campos
      • Patient/Pre-Hospice Consult (p): 361-252-6978
      • Provider Clinical Inquiries (Transitional Concurrent Care) (p): 361-252-6978
  • Visiting Nurse Service of New York (VNSNY) with plans in select counties in NY

Hospice Network Administrative Contact for MAO Participating in CY 2021 ONLY

  • Commonwealth Care Alliance, Inc. with plans in select counties in MA
    Kathy Devaney, (e): kdevaney@commonwealthcare.org and (p): 617-426-0600 Ext. 1306 and alternative (p): 857-216-8480

The Commonwealth Care Alliance (CCA) Hospice VBID Page provides an overview of the program, important links and documents, examples of documents and notifications, sessions sign-ups and key CCA contacts.

Key:

(e): Email address for Hospice Network Administrative Contact

(p): Business phone number for Hospice Network Administrative Contact

Last updated on:
04/22/2022