How to Request Reconsideration if Your Hospice Didn’t Meet HQRP Reporting Requirements
June 14, 2013 02:05 PM
In order to comply with Hospice Quality Reporting Program (HQRP) requirements that affect the annual payment update (APU) for fiscal year (FY) 2014, hospice providers with a valid Centers for Medicare & Medicaid Services (CMS) Certification Number (CCN) as of October 1, 2012 are required to submit data for the structural measure by January 31, 2013. Data for the NQF #0209 Pain Measure must be submitted by April 1, 2013.
Providers that were required to submit data but missed either deadline may be found non-compliant and subject to a 2 percentage point reduction in their APU for 2014.
In June 2013, CMS began notifying, by way of the Medicare Administrative Contractors (MACs), hospices that failed to meet the HQRP requirements. Providers who receive notification of non-compliance will have the opportunity to submit reconsideration requests prior to any reduction in payment.
What to do if you receive notification of non-compliance
Hospices that believe they have been erroneously identified as non-compliant may submit a request for reconsideration to CMS within 30 days from the date of the notification of non-compliance. Any request for reconsideration must be accompanied by supporting documentation demonstrating compliance.
How to submit a reconsideration request
Reconsideration requests must be sent to CMS via email. More detailed instructions on how to submit reconsideration requests can be found on the HQRP Reconsideration Requests web page.
Hospices may submit questions related to the reconsideration request requirements to: HospiceQRPReconsiderations@cms.hhs.gov.