CMS
CMS Shares MFT & MHC Provider Enrollment FAQs
October 2, 2023CMS posted some Frequently Asked Questions (FAQs) to educate mental health counselors and marriage and family therapists on the CY 2024 Physician Fee Schedule (PFS) proposed rule related to the existing enrollment…
FY2024 Hospice Medicare and Medicaid Base Rates
October 2, 2023Beginning October 1, 2023, hospice base payment rates will increase by 3.1 percent, as published in the final FY 2024 Hospice Payment Rule. As is customary, the Medicaid program waits until…
HHAs Inaccurately Report Falls with Major Injury
September 18, 2023On September 5, 2023, the Office of the Inspector General (OIG) issued a report showing that home health agencies (HHAs) failed to report over half of falls with major injury and hospitalization…
CMS Open Door Forum: Key Updates for Home Health & Hospice
September 11, 2023The Centers for Medicare and Medicaid Services (CMS) held a Home Health, Hospice, and DME Open Door Forum on August 30, 2023. The summary of the Forum applicable to home…
CMS Addresses Benefit Integrity Issues in Hospice Care
September 11, 2023On August 22, the Centers for Medicare and Services (CMS) announced enhanced efforts to protect benefit integrity and ensure quality in hospice care. On the agency’s official blog, Dara A….
CGS: NEW Process for 56900 Reopening Requests
September 11, 2023To ensure your 56900 reopening requests are routed and handled efficiently, please use one of these options to submit the appropriate request form and documentation: What is a 56900 denial?…
CMS Suspects Auto-Renewal Issue in Medicaid Disenrollments
September 11, 2023In a letter to all states, the Centers for Medicare & Medicaid Services (CMS) has reported issues with eligibility systems using auto-renewals that lead to wrongful disenrollments from Medicaid and CHIP, particularly…
CMS Releases New Public Use File on Characteristics of Community-Dwelling Medicare Beneficiaries Enrolled in the Low-Income Subsidy Program
June 19, 2023CMS has released a new public use file on socio-economic characteristics of community-dwelling Medicare beneficiaries by Low-Income Subsidy program enrollment status in 2021. The public use file uses data from…
The Office of Management and Budget (OMB) has renewed the Advance Beneficiary Notice of Noncoverage (ABN) form (Form CMS-R-131). The use of the renewed form with the expiration date of 01/31/2026 will be…
CMS Releases Findings from Technical Expert Panel, Listening Sessions on Hospice Special Focus Program Development
May 8, 2023As part of the Consolidated Appropriations Act of 2021 (CAA), Congress enacted significant changes to the hospice survey process, including a Special Focus Program (SFP) for poor performing hospice providers….
April HHVBP Newsletter Now Available
May 8, 2023Home health providers can now access the April 2023 Home Health Value-Based Purchasing (HHVBP) Newsletter. This edition includes information on the April PIPR reports, clarification on measure exclusions for patients…
On April 27, 2023, the Centers for Medicare and Medicaid Services (CMS) released two proposed regulations that would significantly impact Medicaid programs, if finalized. Ensuring Access to Medicaid Services Proposed…
Details Released on Medicare Advantage Value-Based Insurance Design (VBID) Model Extension
April 7, 2023The Medicare Advantage (MA) Value-Based Insurance Design (VBID) model will be extended for calendar years 2025 through 2030, and will introduce changes intended to more fully address the health-related social needs of…
On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) issued Medicare Program; FY 2024 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice…
On March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the…
Last week, the quarterly Hospice Quality Reporting Program (HQRP) Update was distributed to hospices via email. This quarter’s update includes FY 2024 HQRP reporting reminders, public reporting updates, and upcoming training…
Last week, the CMS Innovation Center announced that the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model will be extended for calendar years 2025 through 2030 and will introduce changes…
Last week, the Centers for Medicare and Medicaid Services (CMS) added two new training resources to the Home Health Quality Reporting Program (QRP) Training webpage:
Last week, PHA submitted comments to CMS on proposed changes to the Medicare Advantage (MA) program. PHA raised concerns about the proposal’s potential impacts on premiums and benefits for MA beneficiaries and…
The Centers for Medicare and Medicaid Services (CMS) has shared additional guidance on submitting claims with the new G-codes for telehealth encounters, including:
CMS Releases Report on Home Infusion Therapy Services
February 27, 2023CMS has released the Home Infusion Therapy (HIT) Monitoring Report for February 2023, which includes benefit use data from the first quarter of 2020 through the second quarter of 2022. The report…
Regulatory Round Up: Federal Comment Due Dates Approaching
February 13, 2023As a reminder, a number of proposed rules are currently open for public comment at the federal level, including:
Updated HHQRP User Manual Now Available
February 13, 2023The Home Health Quality Reporting Program (HHQRP) Measure Calculations and Reporting User’s Manual has been updated to reflect quality measure changes implemented since the Manual Addendum Update in October 2020. These changes…
CMS Updates Hospice Survey Protocol
January 30, 2023On January 27, the Centers for Medicare and Medicaid Services (CMS) issued memo QSO-23-08-HOSPICE: Revisions to Hospice-Appendix M of the State Operations Manual and the Hospice Basic Surveyor Training. CMS has modified…
CMS Releases OASIS Quarterly Q&As
January 30, 2023The January 2023 Quarterly OASIS Q&As are now available. In this update, CMS addresses the transition from OASIS-D to OASIS-E and provides clarification on several items on the new OASIS-E instrument, including:
CMS Publishes Monthly HHVBP Newsletter + January 2023 PIPR Reports Now Available in iQIES
January 30, 2023Home health providers can now access the January 2023 Home Health Value-Based Purchasing (HHVBP) Newsletter. This month’s edition focuses on the expanded HHVBP Model performance feedback reports and includes an overview…
CMS Proposes Rule to Establish Standards, Simplify Exchange of Electronic Health Data
January 23, 2023On December 21, 2022, the Department of Health and Human Services (HHS) issued a proposed rule that would establish a set of standards for the electronic exchange of clinical and administrative data…
CMS Open Door Forum Includes Updates for Home Health & Hospice
January 16, 2023On Wednesday, January 11, CMS held a Home Health, Hospice, and DME Open Door Forum, with updates on the following:
On January 5, 2023, the Centers for Medicare and Medicaid Services (CMS) issued Change Request (CR) 13040 to detail the requirements of a direct mailing from the Medicare Administrative Contractors (MACs) to…
CMS Proposes Policy Changes for MA Plans
January 16, 2023On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise regulations governing Medicare Advantage (MA or Part C), the Medicare Prescription…
CMS Reactivates Reason Code 31755
January 16, 2023CMS has reactivated Fiscal Intermediary Shared System (FISS) reason code 31755, which requires the revenue code 0023 line-item date of service to match the date of service of a home…
Hospices should be required to report every example of neglect or abuse, even if the offender is not an employee, according to recommendations in a new report from the Government Accountability Office…
Hospice Quality Reporting Program Quarterly Update Available; Sign Up to Receive Updates Via Email
January 9, 2023The Q4 2022 Hospice Quality Reporting Program (HQRP) Update has been posted to the HQRP Requirements and Best Practices webpage. As a reminder, this is the last HQRP Quarterly Update that…
Home Health Rural Add-on Payment Extended
January 9, 2023Section 4137 of the Consolidated Appropriations Act, 2023 extends the 1% rural add-on payment for home health periods and visits that end in CY 2023 for counties classified as ‘‘low population density.’’…
Effective January 1, 2023, Home Health Agencies (HHAs) may begin voluntarily reporting the new telecommunications G-codes on HH claims with HH periods of care that start on or after January…