CMS
CMS Updates Medicaid Eligibility Standards for 2025
December 8, 2024The Centers for Medicare & Medicaid Services (CMS) released updates to Medicaid income and asset standards effective in 2025. Key changes include: Access the bulletin with full details https://www.medicaid.gov/federal-policy-guidance/downloads/cib11152024.pdf.
January 2025 HH PPS Grouper Software Update Now Available
December 8, 2024The January 2025 release of the Home Health PPS Grouper Software (v06.0.25) is now live. Access it in the CMS Downloads section. Key Updates include: More Information:
Register for the Hospice Quality Reporting Program webinar hosted by CMS on Thursday, December 12, 2024, from 1:00–2:00 PM. The webinar will include an Introduction to Hospice Outcomes and Patient…
Care Compare Quarterly Refresh – November 2024
December 8, 2024The November 2024 quarterly refresh for the Hospice Quality Reporting Program is now available on Care Compare. For additional information, please see the FY2025 Hospice Wage Index Final Rule at https://www.cms.gov/Center/Provider-Type/Hospice-Center. Please…
CMS Hospice Quality Reporting Program (HQRP): Q3 2024 Q&A Highlights
November 17, 2024The Centers for Medicare & Medicaid Services (CMS) has released the latest Quarterly Q&A document for the Hospice Quality Reporting Program (HQRP), covering inquiries received during the third quarter of…
CGS Reminder: Termination of the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model on December 31, 2024
November 17, 2024The Centers for Medicare & Medicaid Services (CMS) has decided to conclude the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model as of December 31, 2024, 11:59 PM….
CMS Leadership National Update: November 20, 2024
November 17, 2024Join the Administrator of the Centers for Medicare & Medicaid Services (CMS), Chiquita Brooks-LaSure, and her leadership team, who will provide an update on CMS’ recent accomplishments and how their…
October Home Health Care Compare Refresh Now Live
November 3, 2024The October 2024 quarterly refresh for the Home Health Quality Reporting Program is now available on Care Compare. This update includes revisions to Home Health (HH) Outcome and Assessment Information…
CMS Issues Non-Compliance Notifications for Home Health Agencies
November 3, 2024Attention home health agencies: The Centers for Medicare & Medicaid Services (CMS) began notifying agencies identified as non-compliance with the Home Health Quality Reporting Program (HHQRP) for the 2025 Annual…
Hospice CAHPS Corner: Upcoming Deadlines in December
November 3, 2024Participation Exemption for Size Form Now Available: Submit by Dec. 31 The Participation Exemption for Size Form for the CY 2024 CAHPS Hospice Survey is now available on the CAHPS…
CMS Issues Change Request to Allow Home Health Telehealth Services During Inpatient Stays
October 20, 2024On October 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued Change Request 13812 to revise Medicare claims processing. This change allows non-paid telehealth visits to be reported…
NOW AVAILABLE – Updated Quarterly OASIS Q&As
October 20, 2024October 2024 CMS OASIS Quarterly Q&A’s are available in the OASIS Quarterly Q&As section of the CMS QTSO webpage, https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals .
CMS Establishes Hospice Special Focus Program for Enhanced Oversight Despite Concerns About Eligibility Algorithm
October 20, 2024On October 4, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a memo (QSO-25-02-Hospice) outlining the establishment of the Hospice Special Focus Program (SFP). This initiative, mandated by…
The Centers for Medicare and Medicaid Services (CMS) approved amendments to the Adult Autism Waiver (AAW) effective January 1, 2025. A webinar will be hosted on November 8, 2024 at…
Join CMS at the 2024 HCPLAN Summit on November 14! The theme of this year’s Summit is Alignment, Action, Change and will feature speakers across health care providers, payers, policymakers, and patient…
CAHPS Hospice Survey Quality Assurance Guidelines V11.0, Training Materials Now Available
October 20, 2024Hospice Survey vendors must submit an updated attestation statement by December 6, 2024, via email or the SAFE application. Additionally, updated slides from October 10, 2024 vendor training session and…
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…
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…
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…
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…
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…
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…
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…