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) 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:

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
- 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
John Caralyus, (e): John.Caralyus@vnsny.org and (p): 646-300-2898
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