CMS Hosts a Home Health, Hospice and DME Open Door Forum
Several hospice issues were discussed in detail.
November 19, 2014 03:56 PM
During the CMS Home Health, Hospice, and DME Open Door Forum on November 12, 2014, several hospice items were included on the agenda. Those items are summarized below.
To review the home health issues covered in the most recent ODF, please see NAHC Report, November 18, 2014.
Hospice Quality Reporting Program
Hospices have completed the first reporting quarter of the Hospice Item Set (HIS). There are 476 hospice providers that have not submitted any data. Hospices that have not submitted data may receive a 2% reduction to their annual payment update. To begin submitting data hospices need to first sign up for the two required submission IDs. More information can be found at www.qtso.com.
Updated HIS Q&A documents are now available for provider download on the HIS webpage here.
Providers should note that if any information in a Q&A is contradictory to what guidance is in manual or other instructions, the provider is to use the most current information source. For example, the definition of “initiation of treatment” is different in the most current Q&A document than it was previously. The most current information is the most accurate.
Presenters shared some of the error codes hospices have been receiving. The most common error codes on HIS records are administrative, i.e. the CCN number is incorrect, duplicate records, the submitter ID does not match the CCN, etc. Hospices should verify all their administrative information is correct and have an internal system to verify that the record being submitted has not already been submitted.
CAHPS Hospice Survey – CMS confirmed that there is no change in the planned implementation dates. Hospices will need to choose a vendor and participate in a dry run for at least one of the first three months (Jan-March) of 2015 with mandatory monthly submission beginning April 2015. CMS is expecting all aspects, including final OMB approval, to be finalized very soon.
There are two links on the CAHPS hospice survey website that providers are encouraged to review. Specifically, hospices are urged to review the list of approved survey vendors and information related to authorization of the vendor by the hospice. The hospice provider will need to choose a vendor, contract with the vendor, and then authorize the vendor to submit data on behalf of the hospice.
Providers should go to the survey website, www.hospicecahpssurvey.org, to download the survey vendor authorization form and complete it. All hospice providers will also need a user account for the CAHPS survey data warehouse to review data submitted by the vendor.
Hospices should not take for granted that the vendor will be submitting data each month and should verify that this is occurring as it impacts the hospice’s annual payment update. Providers should go to the survey website and look for the link to access the survey data warehouse and follow instructions there for requesting the user account.
Hospice Aggregate Cap Calculation
CMS indicated that the 2013 CAP year is the first year that will be affected by the 2 percent sequester. CMS is instructing the MACs to consider both the net reimbursement and the amount of the sequester when calculating a hospice’s cap status - rather than calculating the cap from the net payments received - in order not to negate the intent of the sequester.
Since some of the MACs have already issued cap liability notices for the 2013 cap year, some hospice providers may have an additional liability beyond what they are already aware of. CMS has determined that in cases where a hospice has already received notice for the 2013 cap year that it does not have a liability but, when the MAC applies the new formula is over cap, a liability will not be assessed.
Below are the various links to websites and telephone numbers for the hospice quality reporting program resources:
Contact information for QTSO Technical Help Desk:
(877) 201-4721 or by email at firstname.lastname@example.org.
Link to “Hospice Item Set (HIS)” portion of cms.hhs.gov website is available here.
Link to hospice portion of qtso.com websites available here.
Contact information for Hospice Quality Help Desk: HospiceQualityQuestions@cms.hhs.gov
CAHPS Hospice Survey web site: www.hospicecahpssurvey.org; Technical assistance: email@example.com; Toll free at 1-844-472-4621