On July 17, 2016, the Centers for Medicare & Medicaid Services (CMS) will provide hospices with the new Hospice Timeliness Compliance Threshold Report. This report will be available in the Hospice Provider report category in the CASPER Reporting application.
Hospice Timeliness Compliance Threshold Report displays provider level data regarding Hospice Item Set (HIS) records submitted successfully to CMS. The following information is included in the report:
Provider identification information
Provider CCN and FAC ID
# of HIS Records Submitted
# of HIS Records Submitted on Time
% of HIS Records Submitted on Time
HIS COMPLIANCE REQUIREMENTS & TIMELINE
Hospices are required to submit all HIS records (HIS-Admission and HIS-Discharge records) by the submission deadline. The submission deadline for HIS records is 30 days from the event date (the patient’s admission to or discharge from the hospice).
The timeliness compliance threshold for HIS submissions policies impacts the FY 2018 reporting year, which begins January 1, 2016. The FY 2016 Hospice Final Rule states that beginning with the FY 2018 reporting year, in order to avoid the 2-percentage point reduction in their Annual Payment Update (APU), hospices will be required to submit a minimum percentage of their HIS records by the 30-day submission deadline. CMS will implement this compliance threshold over a 3-year period:
Questions related to the Hospice Timeliness Compliance Threshold Report or threshold requirements can be submitted to the Hospice Quality Help Desk: HospiceQualityQuestions@cms.hhs.gov
This proposed rule outlines the CMS planned changes to home health payment and quality initiatives including Home Health Value-Based Purchasing (HHVBP) and updates to the home health quality measures. CMS is now accepting public comments on these proposed changes through 5pm on August 26, 2016.
Submit comments electronically - to https://www.regulations.gov/document?D=CMS-2016-0111-0002 and follow the instructions under the ‘‘More Search Options’’ tab.
We encourage all home health agencies and stakeholders to read this rule and provide CMS with your feedback on areas where you have questions or concerns.
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1648-P) that would update the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2017. This proposed rule addresses the following anticipated changes:
Rebasing the 60-day Episode Rate - The CY 2017 rebasing adjustment to the national, standardized 60-day payment rate is -$80.95. The overall impact due to the rebasing adjustments is estimated to be a -2.3 percent decrease in HH PPS payments for CY 2017 which is offset by the home health payment update percentage, which would increase overall HH PPS payments in CY 2017 by 2.3 percent.
Updates to Reflect Case-Mix Growth - CMS will implement a 0.97 percent reduction to the national, standardized 60-day episode rate in CY 2017 to account for nominal case-mix growth from 2012 to 2014 (prior to rebasing).
Negative Pressure Wound Therapy (NPWT) - The Consolidated Appropriations Act of 2016 requires a separate payment to be made to HHAs for disposable NPWT devices when furnished on or after January 1, 2017 to an individual who receives home health services for which payment is made under the Medicare home health benefit. The separate payment amount will be set equal to the amount of the payment that would otherwise be made under the Medicare Hospital Outpatient Prospective Payment System (OPPS).
Change in Methodology and the Fixed-Dollar Loss (FDL) Ratio Used to Calculate Outlier Payments - CMS is proposing to change the methodology used to calculate outlier payments, moving from a cost per visit approach to a cost per unit approach (1 unit = 15 minutes).
New IMPACT Act Cross-Setting Measures - CMS is proposing to adopt for the CY 2018 payment determination four measures to meet the requirements of the IMPACT Act. The proposed measures are:
Total estimated Medicare spending per beneficiary (claims-based)
Discharge to the community (claims-based)
Medication reconciliation (OASIS-based).
Payment Penalties related to OASIS Submissions - HHAs that do not submit quality measure data to CMS will see a two percent reduction in their annual payment update (APU). CMS is incrementally increasing the compliance threshold over a three-year period beginning with the reporting period for CY 2017.
Home Health Value-Based Purchasing Model - CMS proposes the following changes and improvements related to the HHVBP Model:
Calculate benchmarks and achievement thresholds at the state level rather than the level of the size-cohort and revise the definition for “benchmark” to state that benchmark refers to the mean of the top decile of Medicare-certified HHA performance on the specified quality measure during the baseline period calculated for each state;
A minimum requirement of eight HHAs in a size-cohort;
Increase the timeframe for submitting New Measure data from seven calendar days to fifteen calendar days following the end of each reporting period to account for weekends and holidays;
Remove four measures (Care Management: Types and Sources of Assistance, Prior Functioning ADL/IADL, Influenza Vaccine Data Collection Period, and Reason Pneumococcal Vaccine Not Received) from the set of applicable measures;
Adjust the reporting period and submission date for the Influenza Vaccination Coverage for Home Health Personnel measure from a quarterly submission to an annual submission; and
Add an appeals process that includes the existing recalculation process and adds a reconsideration process.