Hospice
The Participation Exemption for Size Form for calendar year (CY) 2024 CAHPS Hospice Survey data collection and reporting requirements is now available. Hospices that served fewer than 50 survey-eligible decedents/caregivers in CY 2023 (January…
The latest quarterly Hospice Quality Reporting Program (HQRP) Update was distributed to hospices via email at the end of December. This quarter’s update includes FY 2025 HQRP reporting reminders, upcoming training opportunities,…
The CAHPS Hospice Survey telephone and mail materials from the Quality Assurance Guidelines V10.0 (QAG V10.0) in all approved translations are now available. Survey vendors must use the revised CAHPS Hospice Survey materials beginning…
Medicare Payment Advisory Commission (MedPAC) Recommends a 7 Percent Home Health Rate Cut
December 18, 2023Last week, MedPAC held their annual December public meeting to discuss payment rate adequacy across Medicare programs. Following are notable data points and recommendations from 2022 home health data: Quality…
Medicare Payment Advisory Commission (MedPAC) Recommendations for Hospice Eliminates Rate Update
December 18, 2023Late last week, the MedPAC held a meeting to discuss their draft recommendations for various Medicare programs for their upcoming annual report to Congress, which will be released in March 2024. The draft…
UPDATE: Changes to the Interstate Nurse Licensure Compact
December 4, 2023The Pennsylvania Department of Health (DOH) issued an important update to the multistate licensure (MSL) requirements regarding home care and hospice effective November 30, 2023. The Department will no longer require…
CMS Open Door Forum: Key Updates for Home Health & Hospice
December 4, 2023The Centers for Medicare and Medicaid Services (CMS) held a Home Health, Hospice, and DME Open Door Forum on November 29, 2023. The summary of the Forum applicable to home…
November MedPAC Meeting Highlights Hospice Workplan
November 13, 2023During its November meeting, the Medicare Payment Advisory Commission (MedPAC) presented its hospice workplan for ongoing and new projects, which include evaluations on: More details on each of these projects are provided below….
On November 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2024 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which…
Centers for Medicare & Medicaid (CMS) Releases Hospice Quality Reporting Program Report
November 6, 2023The Centers for Medicare & Medicaid (CMS) has been developing a new Hospice Quality Reporting Program (HQRP) data collection tool – HOPE (Hospice Outcomes & Patient Evaluation). The HOPE is…
On Thursday, October 18, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS), issued two resource documents to help explain to patients the…
New VBID Evaluation Report
October 30, 2023Last month, the Center for Medicare & Medicaid Innovation (CMMI) released the most recent Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model evaluation report. The report highlights participation, flexibilities, and outcomes, as…
On October 11, CMS issued Change Request 13417, which provides instruction to Medicare Administrative Contractors (MACs) on updated interest rates under the Medicare program. Effective October 17, 2023, CMS has instructed…
Many Redetermination requests submitted through myCGS are dismissed because the form is not completed correctly. Digits of the Internal Control Number (ICN) are transposed, codes and modifiers added to the form are…
Quarterly Medicare Credit Balance Reports Due October 30
October 16, 2023As a reminder, the Medicare Credit Balance Report for the quarter ending September 30 is due by October 30, 2023. CGS will suspend all claim payments at 100% if a completed…
On September 26, 2023, the Centers for Medicare & Medicaid Services (CMS) announced the Medicare Advantage (MA) plans that will be participating in the MA Value-Based Insurance Design Model (VBID) during calendar…
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…
CMS has released an updated version of the 2021 Medicare Post-Acute Care and Hospice Provider Utilization and Payment Public Use File (PAC-PUF). As a reminder, the PAC PUF presents summarized information on services…
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….
Secretary of State Al Schmidt announced last Tuesday that Pennsylvania is taking the first step to implement the Nurse Licensure Compact by allowing nurses with multistate licenses issued by 40…
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 is providing notifications to hospices that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2022, which will affect their FY 2024 Annual…
CGS has posted the top Q&As received during the “All You Need to Know About the Physician Certification of Terminal Illness (CTI)” training webinar held in May. See below for…
First Quarterly Q&A of 2023 Now Available The HQRP Quarterly Q&A for Q1 2023 is now available. This Q&A includes selected questions received by the Hospice Quality Help Desk during the first…
On May 15, 2023, the Office of Medical Assistance Programs (OMAP) issued a Managed Care Operations Memo (MCOPS Memo) to the Physical HealthChoices Managed Care Organizations (PH-MCOs) to restate and update…
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….
As a reminder, on April 11, 2023, the HHS Office of Civil Rights (OCR) issued a “Notification of Enforcement Discretion” that provides “a transition period for health care providers using…
Effective May 1, 2023, claim and eligibility-specific calls received in the Provider Contact Center (PCC) will need to be properly authenticated by the Computer Telephony Integration (CTI) system prior to speaking to a…
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…
State Board of Nursing Issues Policy Clarifying CRNPs Ordering/Supervising Use of Conscious Sedation Medication
April 3, 2023On April 1, 2023, the Pennsylvania State Board of Nursing issued a Statement of Policy to clarify circumstances under which CRNPs can order and supervise the administration of conscious sedation.
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…
CGS Shares Tips on Responding to Additional Documentation Requests (ADRs) for Hospice Claims
March 27, 2023Medicare Administrative Contractor (MAC) CGS has shared the following information to help providers respond to Additional Documentation Requests (ADRs).
On February 24, the Drug Enforcement Administration (DEA) released a proposed rule intended to govern the prescribing of controlled substances via telemedicine at the end of the COVID-19 Public Health Emergency (PHE)….
CGS Provider Alert: Provider Responsibility When Using Billing Companies and Outsourced Agencies
February 27, 2023Please see below for a recent provider alert issued by CGS regarding the use of billing companies or outsourced agencies. The Centers for Medicare & Medicaid Services (CMS) requires providers,…
CGS: Tips to Reduce Medicare Hospice Claim Denials
February 20, 2023Did you know that the leading cause of Medicare hospice claim denials is lack of proper documentation of a terminal prognosis of 6 months or less? Between July and September…
MedPAC, MACPAC Release Updated Data on Dual-Eligibles
February 6, 2023The Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC) have released an updated data book: Beneficiaries Dually Eligible for Medicare and Medicaid.
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…
CGS is seeing an increase in claims where hospice providers are not billing with Occurrence Span Code (OSC) 77 and applicable dates when appending the KX modifier on all claims…
NHPCO Releases 2022 Hospice Facts and Figures Report
January 30, 2023The 2022 NHPCO Facts and Figures Report is now available. This annual report highlights key data points related to the delivery of hospice care, including information on patient characteristics, location…
CMS Adds Home Equity Page to Home Health, Hospice Quality Reporting Program Websites
January 30, 2023CMS has added a Health Equity page to both the HQRP and HHQRP websites as a means of further advancing health equity for individuals served by CMS programs. These pages include links to additional…
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…
MedPAC Votes on 2023 Recommendations to Congress
January 16, 2023Last Thursday, the Medicare Payment Advisory Commission (MedPAC) met to vote on its annual recommendations to Congress regarding payment policy and reporting requirements. The session included votes confirming recommendations discussed…
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…