Pay-for-Reporting Performance Requirement Discussion

CMS Open Door Forum For Home Health & Hospice

Proposed Rule for 2013 for Home Health.

CMS held an Open Door Forum for Home Health, Hospice and DME Wednesday, July 11, 2012. In case you missed the live call, I have put together some of the highlights of the call for Home Health and Hospice:

Proposed Rule

As noted in my blog yesterday and mentioned in the ODF call, CMS has posted the CY2013 Proposed Rule. On the call CMS provided a high level review of the items included and mentioned that  payments to home health agencies (HHAs) are estimated to decrease by approximately 0.10 percent, or $20 million. Agencies will have until September 4th to submit comments. To see information about the proposed change, agencies can review the blog I posted yesterday.  In addition, I will be providing a free webinar on August 9th to discuss in detail the changes.

Hospice

  • CMS recommended that agencies review the section of the CY 2013 proposed rule that deals with hospice, which is outlined on pages 85-93.  Additionally information can be found on the CMS Hospice Quality reporting website.
  • The video files and Q&A from the April Hospice Quality Training webinars are now available on CMS’ website.
  • CMS is committed to developing a hospice quality reporting program that utilizes standardized methods to collect data needed to calculate quality measures. To accomplish this, they are working with nine hospices around the country on initial development and testing of a patient level data item set that could be used by all hospices in the future to collect and submit standardized data. The pilot is scheduled to run from June 2012 through September 2012.
  • Reminders about the following CRs were discussed: CR 7838  “Updates to Caps and Limitations on Hospice Payment” moved the cap section of the hospice claims processing manual to the hospice benefit policy manual and updated the aggregate cap policy to reflect the changes in cap policy which were finalized in the August 4, 2011 Hospice Wage Index Final Rule;  CR 7675 “Revisions to the Hospice Medicare Summary Notice (MSN)” and 7677 “New Hospice Condition Code for Out of Service Area Discharges“ as discussed in the previous ODF both became effective July 1st. Additional information can be located at the CMS Hospice center website.

Home Health

  • The Home Health Quality Reporting section in the proposed rule is not included in the table of contents and can be found in section III C. Due to there being very little changes this year the OASIS Errata was not published in June and will be published in December.
  • Home Health CAHPS will be publically reported next week on July 19th when the Home Health Compare website is refreshed. Review your preview reports now. July 19th is also the deadline for CAHPS vendors to submit first quarter of 2012 data. CMS reminded agencies that the only official and accurate source of Home Health CAHPS survey information is the https://homehealthcahps.org/ website and agencies should be wary of other sites and documents that claim to be.
  • Will Gehne provided an update on the status of the Outlier Claims Processing issue and asked agencies for their continued patience. Unfortunately the recent fixes did not work. CMS has made this issue their top priority. For those not familiar with the issue, due to an error in the calculation of the Home Health Prospective Payment System (HH PPS) 10 percent outlier limitation, the basic calculation of the outlier limitation since January 1, 2010, has been incorrect. For most HHAs, the adjustment once the fix is in place will result in the correction of an underpayment; however for a few, the adjustments will result in the collection of any overpayment not offset by other underpayment amounts.

The next Home Health Hospice & DME/Quality Open Door Forum has been scheduled for Wednesday, August 22, 2012 from 2:00pm-3:00pmET.

July 13, 2012

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