The Centers for Medicare and Medicaid Services (CMS) held a Home Health, Hospice, & DME Open Door Forum (ODF) on August 7, 2013. The following information and updates pertaining to home health and hospice were provided by CMS staff.
FY 2014 Hospice Wage Index and Payment Rate Update
CMS announced that the final rule was posted by CMS on August 2 and printed in the federal register on August 7. The final rule addresses:
- update to the hospice payment rates that are effective October 1, 2013
- additional information regarding coding clarifications
- updates to the hospice quality reporting program
- information about a hospice experience of care survey
- hospice payment reform update
Details on each of these topics and a summary of the final rule was published in NAHC Report on August 6, 2013 in two parts and can be accessed here and here.
HHCAHPS
CMS reported that data for the entire 2012 calendar year is now displayed for both Home Health Compare and HHCAHPS. Home health agency data for HHCAHPS is not displayed until an agency has data for a full year. If a home health agency qualifies for the HHCAHPS exemption it must fill out the proper paperwork in order to receive the exemption. This can be found on the HHCAHPS website here.
CMS reminded providers to verify that vendors are submitting HHCAHPS data as required. Monthly data submission reports can be accessed on the www.homehealthcahps.org website and going under the Review Data Submission Reports section to verify that your vendor is submitting data as required. If there is a problem, the home health agency must notify the vendor immediately so the vendor can fill out the proper reports for any missed months.
CMS.net Upgrade
A Mandatory upgrade to the CMSNet Juniper Client will occur for Eastern states on August 17, 2013 and for Western states on August 31, 2013. QIES users who connect to CMS Systems using CMSNet must follow the instructions in a new users guide document available here.
Status Update on Home Health Advance Beneficiary Notice
Home health agencies should continue using the HHABN with the date 10/31/12 in the lower left corner.There is not an updated notice available at this time. CMS will continue to provide monthly updates on the status of replacing the HHABN with the regular ABN form and implementing a new Home Health Care of Care Notice (HHCCN).
Home health agencies are encouraged to check the CMS HHABN webpage periodically for posting of these notices. Once posted, agencies can begin using the notices immediately but will be required to implement them within 60 days after being posted. NAHC will be checking the webpage routinely and providers can also check it here.
OASIS C1
The OASIS C1 Paperwork Reduction Act (PRA) package is now available here.
Comments are due to CMS by August 20, 2013. NAHC is compiling comments. Please send your input mkc@nahc.org
Home Health Quality Measures
Two postings will be on the home health quality measures program site revised home health measures (outcomes measures table, POE table, process measures table) and the home health agency quality measure technical document of OASIS based outcome measures.
There has been some question about the calculation of the quality measures. CMS reported that the measure calculations are correct but the documentation of the calculation of the measures is what is incorrect. So that document will be corrected and uploaded to the CMS website. The revised date for that documents will be July 2013.
Providers can access this information here on CMS website.
Hospice Quality Reporting Update
CMS reported that training materials on the data collection requirements -which impacts a hospices FY2015 Annual Payment Update (APU) - will be available in the next few weeks. There will also be an updated fact sheet, a user guide for data collection, and a PowerPoint slide show to help hospices understand the FY2015 reporting requirement
The Fact Sheet provides a general overview of the reporting cycle and what providers should be doing to prepare. The Users Guide and training slides will have more detail about the structural measure and the pain measure. There will be no live presentation.
In addition, s document detailing the results of the NQF #209 Pain Measure will soon be available under the downloads and spotlight section of the hospice quality reporting webpage.
Data from the HIS pilot test will also be available here.
Open Q&A
The CMS panel was asked when hospice providers would be notified of the hospice CAP rates for this year and CMS responded that this communication will occur through a Change Request (CR) as it has in the past.
A question of clarification was also asked regarding the use of Adult Failure to Thrive (AFTT) and Debility as the principal diagnosis on hospice claims. Specifically, the caller asked if these diagnoses can be used up until October 1, 2014 or if CMS will be able to go back for three years prior to this date for enforcement. CMS responded that the October 1, 2014 date is the date enforcement will begin and the CMS panel does not recall a three-year look back period mentioned in the clarifications found in the final rule.
All the webpage addresses for topics discussed in the ODF are available on the ODF agenda page of CMS website here.
Additional Information
There are new instructions for expedited determinations in Original Medicare, released as CMS Transmittal 2711. They will be included in the CMS claims processing manual, Chapter 30. These instructions are optional now and mandatory beginning August 26th of this year.
A link to the new instructions may be found here.
