VBID Model Hospice Benefit Component Participating Plans

VBID Model Hospice Benefit Component Quick Links:

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
- Hospice Network Administrative Contact [Hospice provider network / contracting assistance]
- Amy Kraft, (e): Amy.Kraft@regence.com; (p): 503-553-5055
- Provider Administrative Support Contact [Member eligibility, claims billing, etc.]
- Provider Customer Service, (p): 800-253-0838
- Provider Website: https://www.regence.com/provider/products/medical/medicare
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
- Primary: (p): *Oahu – 1-808-948-6330 or *Neighbor Islands – 1-800-790-4672 toll-free
- Website for providers: https://prc.hmsa.com/s/article/Medicare-Advantage-Hospice-VBID-TCC
- Secondary: Dr. Toby Smith; (e): toby_smith@hmsa.com
Humana Inc. with plans in select counties in CO, GA, IN, KY, OH, VA, and WI
- Primary: Kevin Curey, (e): kcurey@humana.com; (p): 502-580-4059
- Secondary: Cassie Gochenaur; (p) 502-292-8371
- Provider-facing Mailbox: hospiceVBID@humana.com
- Humana’s information for hospice providers: https://www.humana.com/hospice
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.org; and
  - 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:
  - Administrative: email scalhcs-divert@kp.org or call 1-626-405-5903
Presbyterian Healthcare Services (PHS) with plans in select counties in NM
- Participating Presbyterian Senior Care plans include H3204-001, H3204-007 and H3204-008
- Submitting Notices of Election (NOE) and claims
  - Please submit NOEs via the Electronic Data Interchange (EDI) process, working with your clearinghouse. If you are unable to submit via EDI, please send the NOE to PHS’s secure email box: PHPHospiceNOE_NOTR@phs.org
- Contracted Providers may view and submit claim inquiries by going to this link: https://www.phs.org/providers/Pages/default.aspx and registering for the Provider Portal.
- For general inquiries, including contracting questions, contact PHS’s provider network Executives. A list of contacts is here: http://docs.phs.org/idc/groups/public/@phs/@php/documents/phscontent/pel_00140718.pdf
- View PHS’s frequently asked questions document at: https://mailchi.mp/2eeb4ad2ea87/presbyterian-shares-hospice-vbid-fact-sheet-and-faqs
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: John Caralyus; (e): John.Caralyus@vnsny.org; (p): 646-300-2898
- Hospice Provider Billing: Tacheima Bien-Aime; (e): Tacheima.Bien-aime@vnsny.org
- VNSNY’s Hospice FAQ page: https://www.vnsnychoice.org/hospice-benefit/

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