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) 2021, nine Medicare Advantage Organizations (MAOs) will participate in the Hospice Benefit Component, offering 53 plan benefit packages (PBPs). A downloadable list of PBPs with service area and additional contact information can be found here.

Hospice Network Administrative Contact for Hospice Benefit Component-Participating MAOs

  • 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.

  • 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
    Primary: Kevin Curey, (e): kcurey@humana.com and (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, UT
    Primary: Russell Gardner; Secondary: Chris Engh
    Primary (e): Russell.gardner@selecthealth.org; Secondary (e): chris.engh@selecthealth.org
    Primary (p): 801-442-7282; Secondary (p): 801-442-9075
     
  • 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:
  1. Send the Notice of Election to KP-NOE@kp.org; and 
  2. 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
    • Clinical: contact KFHP Valleys Continuing Care Hospice Agency, Director of Patient Care Services at 1-800-863-9293
  • Presbyterian Healthcare Services with plans in select counties in NM
    Brady Gear, (e): bgear@phs.org and (p): 505-923-5805
     
  • Summit Master Company, LLC with plans in select counties in PR
    Primary: Zoe Pizarro, (e): zoe.pizarro@mso-pr.com and (p): 787-622-3000 ext. 5165
    Secondary: Provider Services’ Department at 787-993-2317 or 1-866-676-6060
     
  • Triple-S Management Corporation with plans in select counties in PR
    Primary: Myra M. Velez Plumey, (e): myra.velez@ssspr.com and (p): 787-749-4949 ext 832-6354
    Secondary: Provider’s Call Center: 1-855-886-7474
     
  • Visiting Nurse Service of New York (VNSNY) with plans in select counties in NY
    Tamara Romero , (e): tamara.romero@vnsny.org and (p): 212-609-7546
    VNSNY’s Hospice FAQ page:https://www.vnsnychoice.org/hospice-benefit/

Key:

(e): Email address for Hospice Network Administrative Contact

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

Last updated on:
03/23/2021