Home Health & Hospice Week

TEP report may signal what will be in forthcoming proposed rule.

The home health proposed rule for 2024 likely won’t be out for another six to eight weeks, but you can look at a recent report for clues on a critical hospice provision.

Background: The Consolidated Appropriations Act enacted in December 2020 required the Centers for Medicare & Medicaid Services to implement a Special Focus Program to single out poor-performing hospices for additional survey scrutiny (see HHHW by AAPC, Vol. XXX, No. 1). CMS proposed an SFP in its 2022 home health rulemaking cycle, but pushed it back after receiving a plethora of negative comments on the topic. Last year, CMS indicated it would conduct a Technical Expert Panel discussion and then propose the program in this year’s 2024 rulemaking cycle.

CMS conducted the TEP meetings as planned, as well as four additional “listening sessions,” SFP contractor Abt Associates indicates in a new report summarizing those events. Hospices thought the agency might include the SFP proposal in the 2024 hospice proposed rule, but CMS will once again include the provision in its home health rule. That rule is usually out in late June or early July.

In the meantime, hospices can get some hints at the policy’s final configuration from the TEP summary.

For example: How CMS will choose hospices for inclusion in the SFP has been of utmost concern to the industry. In the report, Abt indicates that the selection process should use “a variety of hospice data sources, including hospice survey data (condition-level deficiencies [CLDs] and substan­tiated complaints), the Hospice Care Index (HCI) (which uses Medicare claims data), and consumer evaluations from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey Star Rating.”