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  NAHC Report: Issue# 2861, 3/10/2016
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Important Hospice and Home Health Provider Reminders
CMS Open Door Forum Examines Claims Processing, Quality Reporting Issues
For Your Information: NAHC Announces the March on Washington Conference
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Important Hospice and Home Health Provider Reminders

While the following issues have been addressed in previous NAHC Report articles and on the NAHC member listserv, the National Association for Home Care & Hospice (NAHC) reminds home health and hospice providers of the following forthcoming deadlines.  Please share this information with appropriate staff to ensure agency compliance.

March 16 - 21:  QIES System Down Time Scheduled for NEXT WEEK -- Mark your Calendars and Plan Ahead!    ALL Centers for Medicare & Medicaid Services’ (CMS) Quality Improvement and Evaluation System (QIES)systems will be down from Wednesday, March 16 after 8:00 p.m. (EST) through Monday, March 21, 2016 at 11:59 p.m. (EST).  This downtime will affect all QIES connectivity and systems. This means the national database, CASPER reports, and QW will NOT be available during this time.  Additionally, the HOSPICE ITEM SET (HIS) and HOME HEALTH AGENCY OASIS SUBMISSION SYSTEMS WILL NOT BE AVAILABLE.   This downtime will affect ALL QIES users.  It is critical that affected Providers make the necessary contingency plans to accommodate for this downtime and ensure their data is submitted in a timely manner.  PLEASE ALERT APPROPRIATE AGENCY STAFF TO THIS DEVELOPMENT.

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CMS Open Door Forum Examines Claims Processing, Quality Reporting Issues

Following is a summary of key issues addressed on the March 9 Home Health, Hospice and Durable Medical Equipment Open Door Forum.  Recording of the call is available for listening until 11:59 p.m. on Friday, March 11, by calling: 1-855-859-2056 and using Conference ID: 38504851. 

Claims Processing Updates
Home Health: CMS released CR 9474 which addresses the new condition codes for reporting on home health claims that no skilled service was delivered during the billing period. MACs are instructed to evaluate claims where skilled nursing visits are provided less than once every 60 days.  Code 54 – “No skilled HH visits in billing period. Policy exception documented at the HHA” – should be used on these claims. Claims submitted without the code will be RTP’d (returned to provider).  The provider will then have the option to

  • Add any accidentally omitted skilled services to the claim
  • Submit the claim as non-covered, if appropriate
  • Append the new condition code

CMS also reminded home health agency providers that the PC Pricer software is being modernized and has not yet been released.  An expected release date was not provided.

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NAHC Announces the March on Washington Conference
Mayflower Renaissance Hotel, April 3–5, 2016

NAHC is hosting the 2016 March on Washington Conference in the splendid city of Washington, DC. Now is a critical point as we face new rules that could challenge our mission to serve America’s aged, disabled, and ill. Join us as we work to make home care and hospice the center of health care in our country.

The nation’s capital is the heart of legislative activity that affects home care and hospice. That makes it the perfect place to raise awareness of the vital work we do. Together, we can deliver a unified message to those who make the policies that shape our business. Take advantage of this chance to lobby your lawmakers, connect with colleagues, and attend educational sessions led by experts in our field.

Register and Book Your Hotel!

View the Conference Program!


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