CMS
Important Change: The May 1 go-live date for the Medicare hospice certifying physician enrollment requirement is delayed until June 3. The hospice physician enrollment requirement was originally set to begin on…
Care Compare Quarterly Refresh – April 2024
April 29, 2024The April 2024 quarterly refresh for the Home Health Quality Reporting Program is now available on Care Compare. For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will…
REMINDER: The Medicare Credit Balance Report for the quarter ending March 31 is due by April 30, 2024. CGS Administrators, LLC (CGS) will suspend all claim payments at 100% if a completed…
There is a new location for accessing the Patient Assessment Change Request Forms effective immediately. The Change Request Forms for MDS, OASIS, IRF, LTCH, and Hospice can be found at…
Beginning May 1, 2024, physicians must be enrolled in or validly opted out of Medicare to certify a patient’s terminal illness under the Medicare hospice benefit. CMS has indicated hospices…
Hospice Item Set (HIS) Manual V3.02 Now Available
April 22, 2024An updated HIS Manual V3.02 is now available. The updates include an extension of the documents expiration date and several minor edits and date corrections. Updated documents include the HIS…
As reported in last week’s Connections, the fiscal year (FY) 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements proposed rule has been…
HHAs: Preview Reports, Star Rating Preview Reports for July Refresh Now Available in iQIES
April 8, 2024Home health providers can now access their Preview Reports and Star Rating Preview Reports for the July 2024 refresh in iQIES. For this refresh Home Health (HH) Outcome and Assessment…
This blog introduces the Quality Pathway, a new initiative focusing on enhancing quality in healthcare. Authored by Dr. Susannah Bernheim, Chief Quality Officer at the CMS Innovation Center, and titled…
The U.S. Department of Health and Human Services (HHS), under the Centers for Medicare & Medicaid Services (CMS), has finalized a rule aimed at enhancing access to care and safeguarding…
The Next Generation Accountable Care Organization (NGACO) Model’s final report has been released, detailing lessons learned from its implementation between 2016 and 2021. This model aimed to improve value and…
On March 27, CMS issued a release regarding the Biden-Harris Administration’s final rule aimed at enhancing the enrollment process and maintaining health coverage for millions of Americans under Medicaid, the Children’s Health…
CMS Proposes 2.6% Pay Raise for Hospices in 2025
April 1, 2024The Centers for Medicare & Medicaid Services (CMS) have proposed a 2.6% pay raise for hospices in the fiscal year 2025. This increase amounts to $705 million compared to FY…
In a post-acute care outreach email, CMS included that a new page has been added to help hospice providers with correcting demographic data. The page, “How to Update Hospice Demographic Data,”…
There will be a temporary pause in distributing CBRs and PEPPERs as CMS works to improve and update the program and reporting system, effective through the fall of 2024. For…
CMS Releases Tool to Help Health Care Providers and Organizations Check Whether or Not They Are Considered HIPAA Covered Entities
March 25, 2024The Centers for Medicare and Medicaid Services has released a new tool to help providers, clearinghouses, and health plans determine if an organization or individual is covered under the Administrative…
CMS Issues Revised Interpretive Guidelines for the Home Health Conditions of Participation (CoPs)
March 25, 2024The Centers for Medicare & Medicaid Services (CMS) has updated Appendix B of the State Operations Manual (SOM) to provide guidance for surveyors in assessing home health agencies (HHAs). These updates reflect…
2024 HCBS CAHPS Report: Participants Satisfied with Quality of Care, Workforce Issues Still Impacting Access
March 18, 2024Individuals receiving Medicaid home and community-based services are overwhelmingly satisfied with the care they receive, yet ongoing workforce issues continue to impact access to care, according to the2024 Home and Community-Based…
Claims Processing Issue: Claims Returning to Provider in Error Due to NOA Offline (Reason Code 19963)
March 18, 2024CGS continues to receive questions from home health providers regarding claims that were returned in error because the corresponding NOA is offline (reason code 19963). If you identify claims that…
New HHVBP Newsletter Highlights Quality Measures + PHA HHVBP Webinar Track Kicks Off March 25!
March 18, 2024Home health providers can access the March Home Health Value-Based Purchasing (HHVBP) Newsletter. This month’s edition includes information on interim performance reports, a look ahead in 2024, a review of the…
CMS Issued Revised Hospice Model Statement
March 18, 2024The Centers for Medicare and Medicaid Services (CMS) has released an updated Hospice Model Election Statement, dated March 2024. Hospices utilizing the CMS Model Election Statement or incorporating its language into…
The Centers for Medicare and Medicaid Services (CMS) has updated its enrollment FAQs for marriage and family therapists and mental health counselors. This update includes new resources and provides clarification on supervision…
Last month, the CMS MLN Connects newsletter clarified “that hospice and skilled nursing facility medical directors and administrators are always considered managing employees for Medicare provider enrollment purposes. You must report all current…
On March 1, the Centers for Medicare and Medicaid Services (CMS) issued Change Request (CR) 13449 to establish and implement a new “stay of enrollment” status for Medicare-enrolled providers in an effort to…
Hospices now have access to additional resources in the Provider Toolkit on the HQRP Requirements and Best Practices page, including three recently added guides: Additionally, CMS has added the Quarterly Q&A…
Last week, the Centers for Medicaid and Medicare Services (CMS) announced the discontinuation of the Hospice Benefit Component in the Value-Based Insurance Design (VBID) Model, effective December 31, 2024. This decision comes…
CMS Updates Manuals to Include Marriage and Family Therapists, Mental Health Counselors
March 11, 2024The Centers for Medicare and Medicaid Services (CMS) has updated its manuals to reflect Medicare coverage and payment for marriage and family therapists (MFTs) and mental health counselors (MHCs) effective…
Recently, the Centers for Medicare & Medicaid Services (CMS) Open Door Forums (ODFs) switched from phone to webinars and now include an online registration process. Last week, CMS shared the…
The deadline for home health agencies to submit a request for an exemption from participating in the Home Health CAHPS (HHCAHPS) Survey for the CY 2025 Annual Payment Update (APU)…
CMS Releases Updated Medicaid Telehealth Toolkit
February 26, 2024The Centers for Medicare & Medicaid Services (CMS) released an updated version of the Medicaid and Children’s Health Insurance Program Telehealth Toolkit on February 8. The toolkit articulates the policies…
February 2024 Refresh Now Live on Hospice Care Compare
February 26, 2024The February 2024 quarterly refresh for the Hospice Quality Reporting Program is now available on Care Compare. Publicly reported hospice quality data, including the Hospice Item Set, CAHPS Survey Family Caregiver…
MLN Matters: Hospices Required to Report All Managing Employees
February 26, 2024The Centers for Medicare & Medicaid Services (CMS) recently clarified that hospice medical directors and administrators are always considered managing employees for Medicare provider enrollment purposes. You must report all…
On February 8, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule, Medicare Program: Strengthening Oversight of Accrediting Organizations and Preventing Accrediting Organization Conflict of Interest, and Related Provisions….
Expanded HHVBP Model: January 2024 Interim Performance Reports (IPRs) Are Available on iQIES
February 19, 2024Home health agencies (HHAs) can now access their January Preliminary Interim Performance Reports (IPRs) for the expanded Home Health Value-Based Purchasing (HHVBP) Model in iQIES. The quarterly IPRs provide HHAs…
Hospice Preview Reports for the May 2024 Refresh Now Available
February 19, 2024Providers 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…
Notice: Hospice Item Set Manual Update
February 19, 2024The Centers for Medicare & Medicate Services has updated the Hospice Item Set (HIS) Manual to remove COVID-19 public health emergency references, revise the Annual Payment Update (APU) penalty to reflect the…
CMS Fact Sheet: Hospice Comprehensive Assessment Measure
February 19, 2024The Centers for Medicare & Medicaid Services recently shared a Fact Sheet for the Hospice Comprehensive Assessment Quality Measure. The document provides clarification on the measure and guidance on how to calculate…
CMS Issues RFI on Medicare Advantage Data Collection
February 12, 2024The Centers for Medicare & Medicaid Services (CMS) has issued a request for information (RFI) seeking input from the public regarding various aspects of Medicare Advantage (MA) data. Feedback from stakeholders to…
2021 Data Now Available for the Medicare Current Beneficiary Survey (MCBS) Chartbook
February 5, 2024CMS has added the annual update to the Medicare Current Beneficiary Survey (MCBS) Chartbook with data for 2021. The MCBS Chartbook provides the public with an interactive collection of charts and tables…
2024 HHCAHPS Survey Training Materials Have Been Posted
February 5, 2024The agenda and slides for the self-paced 2024 Introduction to the Home Health Care CAHPS (HHCAHPS) Survey training and the HHCAHPS Survey Vendor Update training are now posted under the…
On January 26, 2024, the Centers for Medicare & Medicaid Services (CMS) forwarded the final Medicaid Access Rule (CMS-2442-F) to the Office of Management and Budget (OMB) for the last review…
Reminder: GUIDE Model Applications Due This Week
January 29, 2024As a reminder, the Centers for Medicare & Medicaid Services is currently accepting applications for the Guiding an Improved Dementia Experience (GUIDE) Model. The deadline to apply is this Tuesday, January 30. The model aims…
MLN Matters: Refillable DMEPOS Documentation Requirements
January 29, 2024Last week, the Centers for Medicare and Medicaid Services issued an MLN Matters article on Refillable DMEPOS Documentation Requirements. Learn about the requirement to contact the patient (PDF) before you refill DMEPOS products.
Hospice Updates from January Open Door Forum
January 29, 2024Earlier this month, the Centers for Medicare & Medicaid Services (CMS) held an Open Door Forum (ODF) for home health, hospice, and durable medical equipment providers. A summary of the…
CMS Home Health Cost Report Now Available
January 29, 2024The Centers for Medicaid and Medicare Services (CMS) has released a new Cost Report Public Use File (PUF) for Home Health, which includes data for 2020–2021. This report includes provider information such…
Home Health & Hospices: Medicare Credit Balance Reports Due
January 22, 2024As a reminder, the Medicare Credit Balance Report for the quarter ending December 31 is due by January 30, 2024. CGS will suspend all claim payments at 100% if a completed CMS-838…
Quarterly HHCAHPS Survey Results Reported on Care Compare
January 22, 2024Home health agencies (HHAs) are informed that Home Health Care CAHPS (HHCAHPS) Survey results from July 2022 to June 2023 are now accessible on the HHCAHPS website under the “Survey Preview Report”…
CMS Shares Updates OASIS Q&As
January 22, 2024The January 2024 CMS OASIS Quarterly Q&As are now available on the CMS QTSO webpage. In this addition, CMS addresses changes to OASIS as a result of the CY 2024 Home Health Final Rule.
Now Available: Updated Guide to Home Health Help Desks
January 22, 2024The updated guide to Home Health Help Desks is now available in the “Downloads” section of the Home Health Quality Reporting Program Help Desks webpage.
Hospice Self-Determined Aggregate Cap Reminder
January 22, 2024As a reminder, hospices are required to self-calculate and submit their Aggregate Cap Report no later than February 28, 2024. More information, including forms and instructions on where to submit your…