Pay-for-Reporting Performance Requirement Discussion

CMS Open Door Forum for Hospice

Topics Included Hospice Payment Reform, Hospice Quality Reporting.

CMS held an Open Door Forum for Home Health, Hospice and DME on February 29th.  There was an encore of the presentation available until midnight on March 2, 2012. In case you missed the live call and the encore we’ve put together some of the highlights of the call for hospice:

Hospice Payment Reform

  • The Affordable Care Act (ACA) requires changes be made to the Medicare payment system for hospices.  An update was provided on this effort.  The changes, which cannot be implemented until October 1, 2013 at the earliest, must be budget neutral in the first year.
  • ASPE contracted with Acumen, LLC to build hospice analytic data files and conduct preliminary baseline analyses in support of hospice payment reform. The baseline analyses are intended to inform and generate discussion with the technical advisory panel and identify topics for future analyses.
  • Abt Associates has a contract that will conclude on March 31, 2012. During the initial contract term they worked on a variety of things including technical advisory panel hosted on 6/30/2011. In a second contract they will continue to convene technical advisory panel meetings; conduct research and analysis; identify potential data collection needs; and research and develop hospice payment model options.

Hospice Quality Reporting

  • CMS thanked agencies who participated in the voluntary reporting period.  There were more than 900 providers that submitted a total of 6,721 QAPI indicators.
  • The data submission format that was used for the voluntary reporting period is not the same format that will be used for the first cycle of required reporting.  This is due to the required addition of the NQF 0209 measure. The new format will require OMB approval in the form of submission of a Paperwork Reduction Act package. There will be a comment period associated and CMS will post the information on the website.
  • CMS has determined that they will not be including FEHC measures in the first round of reporting.  They believe agencies will be happy by this announcement.
  • CMS will be offering free webinars in the April/May timeframe on the NQF 0209 measure.  They will post information on the webinars to the Spotlights & Announcement page of the Hospice Quality Reporting website.

Hospice Change Requests

  • CR 7675 and CR 7677 were reviewed during the call.
  • CR 7675 modifies the information on the Medicare Summary Notice (MSN) to include charge data.  It is anticipated that this will reduce the amount of questions/concerns that beneficiaries have when they review their MSN.
  • CR 7677, related to use of occurrence code 42 and 52.  Occurrence code 42 should only be used to indicate that a patient was discharged due to patient revocation.  Occurrence Code 52 should be used to indicate a discharge “due to the patient’s unavailability/inability to receive hospice services from the hospice which has been responsible for the patient.” An example of this is when the patient no longer resides within the service area of the hospice.

Medicare Non Coverage Notice

  • CMS indicated that they are in the final stages of approval for the Notice of Medicare Non-Coverage and the Detailed Explanation of Non-Coverage.  They anticipate posting these soon.  Once they have been posted providers will have 60 days to implement the new forms.

The next Open Door Forum for Home Health, Hospice & Durable Medical Equipment is scheduled for April 11, 2012 at 2:00pm ET.  CMS will publish additional information approximately one week prior.

Are you concerned that your hospice software vendor won’t be ready for Hospice Quality Reporting? HEALTHCAREfirst will be! Contact us today for more information.

March 6, 2012

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