Home Health & Hospice Week

HQRP noncompliance reduction, transfer billing edit also addressed in forum.>

Medicare officials are ready to give it another go when it comes to displaying the Hospice Visits in the Last Days of Life (HVLDL) and the Hospice Care Index (HCI) claims-based measures on Care Compare.

Recap: The Centers for Medicare & Medicaid Services had scheduled those measures to display in the May refresh for hospices, but then pulled them at the last minute (see HCW by AAPC, Vol. XXXI, No. 19).

Now CMS is ready for them to debut for real in the upcoming August refresh, a CMS official pledged in the June 29 Open Door Forum for home health and hospice agencies. Preview reports for the new measures became available in hospices’ CASPER folders on May 25, the official added. “Although the actual ‘preview period’ is 30 days, the reports will continue to be available for another 30 days, or a total of 60 days,” CMS explains on its Hospice Quality Reporting Program webpage.

A misleading footnote about the data will also go away, a CMS staffer told one hospice caller.

The problem: CMS suppressed the HVLDL and HCI data in May due to problems on the CMS side, but the footnote on Care Compare says “Data suppressed by CMS upon request from the agency.” That message makes it looks like hospices are trying to hide something, the caller complained.

The solution: An additional footnote “will provide clarity” on that issue, the CMS official promised.

Hospices can also watch for an upcoming report on the HCI measure in July, the CMS source said. The technical report will include analysis and information about the HCI quality measure.

Other hospice topics addressed in the forum include:

• HQRP noncompliance. If hospices don’t comply with HQRP requirements, they receive 2 percent less reimbursement (moving up to 4 percent in 2024, based on 2022 data). Notifications for the 2023 update, based on 2021 data, will go out in mid-July, a CMS official said in the forum.

Notifications will come from HHH Medicare Administrative Contractors as well as via the CASPER system, the CMS staffer explained.

• Transfer billing edit. As you may recall, CMS released CR 12619 back in February, indicating a new system edit would not allow any gap days for hospice transfers (see HCW by AAPC, Vol. XXXI, No. 7). Now that that edit is about to take effect on July 1, hospices have some questions.

Namely: When the receiving hospice can’t admit a patient on the day of discharge, an official transfer doesn’t occur, one caller noted. In that case, when the receiving hospice does admit the patient shortly afterward, does the patient continue their current benefit period or start a new benefit period, she asked.

CMS didn’t have an answer for that question in the forum, so stay tuned for clarification.

The four-page MLN Matters Article addressing the CR is at www.cms.gov/files/document/mm12619-gap-billing-between-hospice-transfers.pdf.