CMS ODF Highlights Pending Home Health, Hospice Issues
March 7, 2014 10:40 AM
CMS held a Home Health, Hospice, and Durable Medical Equipment Open Door Forum (ODF) on March 5, 2014. A summary of the items discussed that impact home health and hospice agencies is below.
Change Request (CR) 8539 has an April 1, 2014 effective date (dates of service). This CR adds some HCPCS codes to the non-routine supply list and replaces the speech therapy code 92506 with four more specific speech therapy billing codes.
MLNMatters Article SE1410 was re-released on March 4, 2014. This special edition MLNMatters article provides instructions for ICD-10-CM coding on home health claims with episodes that span October 1, 2014.
Due to a change in how LUPA add on payments are calculated several new fields needed to be added for claims processing and the PC Pricer software updated. The updated software is available on the CMS website but the corresponding User Manual is not yet revised. It is expected that the revised User Manual will be up on the CMS website within two weeks.
Agencies were reminded that there is still time to participate in the current HHCAHPS reporting period but time is running out. Those agencies required to participate but not doing so will have their annual payment update for FY2015 reduced by 2%. To begin participation an agency needs to register, contract with and authorize a vendor. HHCAHPS survey implementation can begin as soon as these steps are complete. Home health agencies without four quarters worth of data cannot participate in the HHCAHPS data submission process. April 17, 2014 is the data submission deadline for fourth quarter 2013 HHCAHPS data. This is a firm deadline. There are no exceptions.
Therefore, agencies were reminded to verify that their monthly data for HHCAHPS is being submitted. Providers can do this by logging in at www.homehealthcahps.org. An agency having trouble submitting the monthly file to their vendor should contact the vendor right away so the vendor can fill out a notification report and submit it to CMS. CMS uses these reports when considering if and HHA has met the reporting requirements for the annual payment update.
The HHCAHPS participation exemption request form for the 2016 annual payment update will be available on April 1 2014. New on the HHCAHPS website is an updated HHA responsibilities paper. The paper can be accessed through the link on the www.homehealthcahps.org homepage. Also coming to the website are announcements about CY2016 requirements.
April 17, 2014, HH Compare, will be refreshed with updated HHCAHPS data through September 30, 2013. Home health agencies can preview their data on the HHCAHPS website beginning April 3, 2014.
On September 26, 2014 home health agencies will transition from submitting OASIS data through state servers to submitting OASIS data through a centralized national server, the Assessment Submission and Processing (ASAP) system. Validation reports for OASIS submitted prior to this date will be available from state servers for 60 days.
Data specification version 2.10.0 is to be used for OASIS C records with a M0090 date before October 1, 2014. These records also use the ICD-9-CM coding guidelines. Version 2.11.0 is to be used for OASIS C records with a M0090 date on or after October 1, 2014. CMS panelists reminded providers that new data submission specifications are on the OASIS website. Providers are encouraged to check this website regularly for updates and changes.
There will be a new OASIS homepage for submitting files with a different URL. This will be available on October 1, 2014. Likewise, there is a new version of Haven, called J-Haven. More information is available here.
There will be an OASIS C-1 training webinar on Wednesday, April 30, 2014. The webinar will run from 2:00 – 3:30 PM Eastern. A live Q&A session will not be part of the webinar due to the need to research answers. Questions should be submitted prior to the webinar to the current OASIS question box at email@example.com.
Further instruction for participating in the training webinar is forthcoming; however, CMS indicated that there will only be 1,000 lines available for this session and access is on a first-come, first-served basis. No pre-registration is required. Providers are strongly encouraged to call in at least 15 minutes prior to the start of the training.
The CMS panel did not address the agenda item Hospice and Part D. Several participants asked questions about this to which CMS responded that there is additional information forthcoming. It was delayed due to an inclement weather closure at CMS Monday. NAHC will let you know as soon as something is released.
Providers were reminded that CR 8358 was re-issued on January 31, 2014 to clarify frequent questions. CMS indicated that the drug reporting requirements apply to all levels of care. NAHC has developed a Q&A document on this subject that members can access here.
CMS representatives reminded providers that the Hospice Quality Reporting Program (HQRP) submission deadline for the FY2015 reporting cycle is 11:59 PM eastern on April 1, 2014. A new account is required for submission of the data. Last year’s accounts are no longer active. Providers can register for new accounts by going to www.qtso.com and clicking the “Register” link in the upper right corner. Only about half of the hospice providers have registered for an account and submitted their data. Any questions about submission should be directed to the help desk at 877-201-4721.
Beginning January 1, Hospices are no longer required to collect data on the pain measure (NQF#209) or the structural measure. They should be preparing for the implementation of the HIS that is effective for all admission on or after July 1, 2014. There was CMS training on the HIS in February. These trainings were recorded and can be accessed at:
HIS Data Collection Training Day 1 (Feb. 4, 2014) is available here.
HIS Data Collection Training Day 2 (Feb. 5, 2014) here.
Providers should familiarize themselves with the HIS Training Manual before listening to the training sessions. Technical training sessions via WebX modules will be available in May. Providers will need to submit all HIS records electronically and will need to register for two CMS user IDs in order to do this. One ID will provide access to the network for submission and the second will provide access to CASPER, which is the module from which providers will access submission and other HIS reports. Access to registering for these IDs through CMS will be available beginning May 19, 2014.
A Hospice CAHPS update was also provided. Hospice CAHPS is the experience of care survey that will be added to the hospice quality reporting program (HQRP) in 2015. Hospices will need to choose and authorize a vendor to administer their CAHPS survey. In January, February or March of 2015 hospice providers will need to do a dry run of the survey. Beginning in April 2015 hospice CAHPS survey data must be submitted monthly to CMS by the hospice’s chosen vendor. Updates to Hospice CAHPS will be delivered through the CMS ODFs and a website specifically for Hospice CAHPS will soon be launched. The web address will be firstname.lastname@example.org.
CMS provided an explanation of the revised cost reporting instructions in cases where hospices contract with critical access hospitals (CAHS) or other hospitals to use the facility’s surplus beds for hospice patients. The revised cost reporting instructions were published in September 2013 in the CMS publication 15-2, Chapter 40, Transmittal 4. Basically, the cost report offsets the CAHS/hospital’s general inpatient care costs by the payment amount received by the hospice. Providers with questions about this can email Darryl Simms at Darryl.email@example.com or call him at 410-786-4524.