CMS
NOW AVAILABLE: HOPE Tool User Manual and Web Based Training
October 6, 2024The Hospice Quality Reporting Program (HQRP) Quality Measure (QM) User Manual Chapter for HOPE Process Measures is now available. This QM Manual chapter contains instructions on the calculation of HOPE-based…
CMS Issues Hospice Prepayment Review Fact Sheet
October 6, 2024On September 4, the Centers for Medicare and Medicaid Services (CMS) issued an MLN Newsletter article, “Hospice Benefit: Expanding Prepayment Review in 4 States.” Under this initiative, CMS, through the MACs, will…
CMS Hosts Training Series for Medicaid Access Rule
September 20, 2024The Centers for Medicare & Medicaid Services (CMS) announced an upcoming training series on the home- and community-based services (HCBS) provisions of the Medicaid Access Rule. The HCBS provisions of…
Expanded HHVBP Model Web-Based Training: Changes to the 2025 Applicable Measure Set
September 20, 2024The Centers for Medicare & Medicaid Services (CMS) is offering a training course which will cover changes to the Home Health Value-Based Purchasing (HHVBP) Model’s applicable measure set for 2025….
Final HOPE Item Sets Released
September 20, 2024Starting October 1, 2025, hospices will begin using the Hospice Outcome & Patient Evaluation (HOPE) tool, which will replace the Hospice Item Set. The final HOPE tool, including HOPE Admission…
On Wednesday, August 21, 2024, the Centers for Medicare & Medicaid Services (CMS) hosted the August 2024 HQRP Forum to provide information on the Fiscal Year 2025 Hospice Final Rule…
August 2024 Refresh of Hospice Care Compare
September 6, 2024Hospice quality data has been refreshed on Care Compare, including Hospice Item Set data, CAHPS® Survey Family Caregiver Experience data, and Star Ratings. In addition, provider preview reports for the November 2024…
CMS Offers Updated Web-Based Training on Section GG Data Elements
September 6, 2024The Centers for Medicare & Medicaid Services (CMS) has introduced an updated series of web-based training courses focused on the assessment and accurate coding of Section GG data elements. These…
On August 21, the Centers for Medicare & Medicaid Services (CMS) released a brief explainer video titled, “Hospice Outcomes and Patient Evaluations (HOPE) Data Collection Timepoints.” This 4-minute, animated explainer…
Providers can now access the latest Provider Preview Reports via the Certification and Survey Provider Enhanced Reports (CASPER) application. Once released in CASPER, providers will have 30 days during which…
As Pennsylvania prepares to move to an 85% threshold for EVV compliance on January 1, 2025, PHA is committed to helping you stay prepared. If you missed our review in…
The Centers for Medicare and Medicaid Services held a webinar on August 13, 2024 to review the HHVBP CY 2024 Annual Performance Report (APR). Those interested in reviewing the presentation…
In March 2024, CMS announced that the Value-Based Insurance Design (VBID) Hospice Benefit Component will end on December 31, 2024. CMS issued technical and operational guidance on August 7 for…
Last week, Secretary Dr. Val Arkoosh announced that Pennsylvania will receive approximately $58 million in federal reimbursement from the Centers for Medicare & Medicaid Services (CMS) through the Money Follows…
Recap of July 30th CMS LTSS Open Door Forum
August 9, 2024On July 30, CMS hosted a Long-Term Services and Supports Open Door Forum. During the call, CMS reviewed the payment adequacy provisions of the Access Rule, with a particular focus…
On July 30, CMS released the FY 2025 Hospice Wage Index and Payment Rate Update. If you missed our earlier announcement, here are the highlights: The final rule is expected…
Expanded HHVBP: Reporting Updates
August 9, 2024The Preliminary July 2024 Interim Performance Reports (IPRs) for the expanded HHVBP Model are now available on iQIES, providing performance data and interim scores for home health agencies. Providers can…
Feedback Needed: Help Improve the PEPPER & CBR
July 29, 2024The Center for Medicare & Medicaid Services (CMS) is seeking information for a reevaluation of the Comparative Billing Reports (CBRs) and Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) to improve…
On July 12, the Centers for Medicare & Medicaid Services (CMS) released guidance to states on the steps needed to ensure compliance with rate transparency provisions of the Medicaid Access…
The Home Health Care CAHPS (HHCAHPS) survey results are now on Care Compare. Survey results are based on responses from patients who received care from Medicare-certified agencies in CY 2023. You…
WEBINAR: HHVBP CY 2024 Annual Performance Report
July 29, 2024The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar on August 13 to inform home health providers about their first Annual Performance Report (APR) for the…
July 2024 MedPAC Data Book Released
July 22, 2024The Medicare Payment Advisory Commission released the July 2024 MedPAC Data Book, Health Care Spending and the Medicare Program, on July 16, 2024. The MedPAC Data Book provides information on national health care…
Recently, hospice providers may have experienced claim rejections due to an issue with the certifying physician enrollment edit. The problem, marked by reason code 17729 (The attending physician’s National Provider…
NOW AVAILABLE IN iQIES – Preview Reports and Star Rating Preview Reports for the October 2024 Refresh
July 22, 2024For the most recent iQIES refresh, Home Health Outcome and Assessment Information Set (OASIS) and QRP claims-based measures have been updated. All OASIS and claims-based measures are now based on…
CMS Launches GUIDE Model to Improve Dementia Care
July 15, 2024On July 1, the Centers for Medicare and Medicaid Services (CMS) launched the Guiding an Improved Dementia Experience (GUIDE) Model. This eight-year, voluntary nationwide initiative aims to support individuals with dementia…
Last week, the Centers for Medicare & Medicaid Services (CMS) released a summary report from the Standing Technical Expert Panel (TEP) convened on December 15, 2023, to develop, evaluate, and maintain Post-Acute…
On July 3, the Centers for Medicare & Medicaid Services (CMS) notified hospices of non-compliance with Hospice Quality Reporting Program (HQRP) requirements for calendar year (CY) 2023, impacting their fiscal…
The HCBS CAHPS survey measures participant experiences in areas such as access to services, communication with providers, choice of services, and personal safety. The insights gathered help home care providers…
The Centers for Medicare and Medicaid Services (CMS) released the CY 2025 Home Health proposed rule, signaling that more significant cuts could be on the way for providers. The proposed…
New Edition of HHVBP Newsletter Focuses on Annual Performance Reports, Future Reporting Schedule
July 1, 2024The latest edition of the Expanded Home Health Value-Based Purchasing (HHVBP) Model newsletter is now available. CMS has announced that the preview CY 2024 Annual Performance Report (APR) will be…
CMS Releases New HQRP Quarterly Update
July 1, 2024The latest quarterly Hospice Quality Reporting Program (HQRP) Update has been released via email, featuring crucial annual payment reminders and details on the FY 2025 reconsideration period. CMS has also…
The Center for Medicare & Medicaid Services (CMS) will host a virtual conference on August 7 and 8 from 12 – 4 p.m. for anyone who processes Medicare Part A…
Section 2718 of the Public Health Services Act, titled “Bringing Down the Cost of Health Care Coverage,” requires each hospital operating within the United States (U.S.) for each year to…
The Centers for Medicare & Medicaid Services (CMS) announced the end of the Change Healthcare/Optum Payment Disruption (CHOPD) Program on July 12, 2024. Launched in March, CHOPD provided financial support…
The Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary has released projections of National Health Expenditures (NHE) and health insurance enrollment for the years 2023-2032. The Office…
The Centers for Medicare & Medicaid Services (CMS) has issued the Final April 2024 Interim Performance Reports (IPRs). These reports, which reflect updates to claims-based measure scores, are now available…
CMS Releases Updated Health Equity Fact Sheet
June 10, 2024On May 24, 2024, the Centers for Medicare and Medicaid Services (CMS) released an updated Health Equity Fact Sheet. Based on this fact sheet, home health, home care, and hospice providers…
CMS Revises Hospice Certifying Physician Enrollment Requirement Implementation Guidance
June 10, 2024On June 6, 2024, in response to concerns raised by the provider community, the Centers for Medicare & Medicaid Services (CMS) retracted its guidance indicating that any individual who elects…
Providers can now access the latest Provider Preview Reports via the Certification and Survey Provider Enhanced Reports (CASPER) application. Once released in CASPER, providers will have 30 days during which…
Medicare Provider Compliance Tips
June 3, 2024Looking for information on The Centers for Medicare & Medicaid Services (CMS) Provider Compliance Tips program? Plus, the new CMS tool provides high level guidance on how to prevent claim denials…
PHA Comments: CMS-1810-P Proposed Rule on FY 2025 Hospice Wage Index and Payment Rate Update
June 3, 2024PHA submitted comments to the Centers for Medicare & Medicaid Services on the recently proposed rule by CMS, titled “Medicare Program; FY 2025 Hospice Wage Index and Payment Rate Update,…
New Edition: HQRP Quarterly Q&As Now Available
June 3, 2024The HQRP Quarterly Q&A for Q1 2024 is now available. This Q&A includes selected questions received by the Hospice Quality Help Desk during the first quarter of 2024 (January 1…
CMS Open Door Forum
June 3, 2024CMS held a Home Health, Hospice, and DME Open Door Forum (ODF) on Wednesday, May 22 to provide updates on the Hospice Quality Reporting Program. Members are encouraged to sign…
On May 3, 2024, The Centers for Medicare & Medicaid Services (CMS) released the following revisions to the State Operations Manual (SOM): These revisions are effective immediately; however, state survey agency…
GAO Releases Medicare Hospice Report Recommending CMS to Implement Statutory Provisions and Prioritize Certain Overdue Surveys
May 13, 2024On May 8, the Government Accountability Office (GAO) released its anticipated report, Medicare Hospice: CMS Needs to Fully Implement Statutory Provisions and Prioritize Certain Overdue Surveys. This report found that CMS…
On April 30, the U.S. House Energy and Commerce Subcommittee on Health held a hearing titled “Legislative Proposals to Increase Medicaid Access and Improve Program Integrity” that included discussions regarding…
The Home and Community Based Services (HCBS) Quality Dataset was first implemented in 2022 with the intent establishing a national quality framework that allows for standardization of quality measurement and improvement activities…
The Preliminary April 2024 Interim Performance Reports (IPRs) for the expanded HHVBP Model have been published on the Internet Quality Improvement and Evaluation System (iQIES). The quarterly IPRs provide HHAs…
Medicaid Access and Accountability 80/20 Rule Released
April 29, 2024The CMS final rule entitled, “Ensuring Access to Medicaid Services,” proposed to address key issues in Medicaid services, was issued this week. PHA issued a statement and is working diligently to review…
CMS Issued Updates to Home Health Claims Processing
April 29, 2024The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 14543, addressing critical aspects of home health care reporting, including county codes, notice of admission exceptions, telehealth service reporting,…