Three New HH 5 Star Tools From CMS and Proposed Hospice 2019 Payment Rule

Posted on Friday, May 18, 2018 2:32 PM

The Centers for Medicare & Medicaid Services (CMS) conducted a Home Health, Hospice and DME Open Door Forum on Tuesday, May 15th, during which representatives provided overviews of several recent regulatory developments in home health and hospice. 

The following is a summary of the call:

Home Health Quality Program

CMS posted three new Home Health Quality Star Rating resources on their website.

  • Star rating FAQ document
  • Star rating fact sheet
  • A revised methodology to reflect the elimination of the Influenza Vaccine Ever Received measure

CMS also issues a new OASIS FAQ found here and announced that they intend to release a new one quarterly in January, April, July and October. 

CMS has issued an updated quality measure specifications document for the cross-setting measure Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened. Also, an updated home health process quality measure table is available. The table has been modified to align with the revised technical specification for the Timely Initiation of Care measure, which was effective for episodes of care starting on or after January 13, 2018.

A Medical Learning Network call has been scheduled for June 27, 2018 on proposed changes to the Quality Star Rating System.  Registration information will be available closer to the call.

Home Health Consumer Assessment of Health Care Providers System (HHCAHPS)

CMS reminded participants that the submission deadline for the HHCAHPS is the third Thursday in January, April, July and October.  The next due date is July 19, 2018.  The exemption form for 2020 is available on the HHCAHPS website.  They also announced that they are working on releasing the HHCAHPS is Armenian soon. 

Home Health Claims Processing Update

CMS issued Change Request 10531 that instructs contractors to install the new Pricer to allow for the 3% rural add-on as required by the Bipartisan Budget Act of 2018. Any eligible claim submitted after April 2, 2018 will reflect the rural add-on. Claims submitted prior to that date will receive an automatic adjustment. The providers have until October, 2018 to complete all of the claims adjustments related to the 2018 rural add-on.

Hospice Proposed FY2019 Payment Rule and Quality Updates

As we reported here, the proposed FY2019 hospice payment rule and quality updates were posted for public viewing. 

The rule proposes minor regulatory text changes to reflect a provision included in the Bipartisan Budget Act of 2018 that authorizes Physician Assistants, effective January 1, 2019, to serve as hospice attending physicians.  However, they are not permitted to conduct the hospice face-to-face encounter or certify a patient as eligible for hospice care.

Hospice CAHPS

CMS staff reminded hospice providers and CAHPS vendors that a variety of translations are currently available but asked for recommendations for other language translations if they are needed.

During the Q & A section of the call, CMS staff confirmed that on Hospice Compare the Hospice CAHPS measures will include not only a Top Box Score (percent of respondents who gave the hospice the highest rating) but also a Middle Box Score (percent of respondents who gave the hospice the middle score) and a Bottom Box Score (percent of respondents who gave the hospice the least favorable score).

Hospice Claims Processing Update

Hospice Claims Processing staff discussed issuance of CR 10573, through which CMS announced that effective October 2, 2018, hospices can start reporting a monthly charge for drugs on claims and a monthly charge for pumps/infusion drugs if they wish to, in lieu of line-item reporting on claims.  CMS also announced that as part of CR 10573 and beginning October 1, 2018, hospices will have access to information related to the number of days of care provided at the high routine home care rate and the number of days of care provided at the lower routine home care rate.  This will help hospices better monitor and manage their financial operations.


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Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

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