Home Health & Hospice Week

HIS Manual, NOE deadline also raised in ODF.

If you want to get in on Medicare’s first test of the concept of concurrent care between hospice and curative care, you have no time to waste.

June 19 is the deadline for submitting applications for the Centers for Medicare & Medicaid Services’ Medicare Care Choices Model — i.e., the three-year demonstration project that will test the concurrent provision of hospice care and fee for service curative care. The demo will focus on patients with advanced cancers, COPD, obstructive heart failure, and HIV AIDS, noted CMS’s Cindy Massuda in the May 28 Open Door Forum for home care providers. “These beneficiaries are hospice-eligible, but are not currently in the Medicare hospice benefit,” Massuda noted.

The demo will pay hospices $400 per beneficiary, per month to provide palliative care services. That will include routine home care and respite care levels of service, Massuda detailed.

“We see this model very much as an integrated health care model, where the hospices are highly integrated with the curative providers and coordinating the services and case managing with the curative providers,” Massuda explained.

CMS wants at least 30 hospices of all sizes in diverse areas of the country to participate, Massuda noted.

Tip: You must submit applications by pro-vider number — you can’t combine locations with multiple numbers. “We are looking to understand the uniqueness of your service area, the uniqueness of your patient populations, based on all your different providers that may be under one umbrella company,” Massuda clarified.

More information, including the request for application and FAQs, is at http://innovation.cms.gov/initiatives/Medicare-Care-Choices.

Other hospice issues raised in the forum were:

• HIS. The July 1 implementation date for the Hospice Item Set is rushing up fast. If you haven’t done so yet, now’s the time to use the technical training and draft HIS Guidance Manual CMS has posted on its website at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/HIS-Technical-Information.html and www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-Item-Set-HIS.html.

However, hospices are frustrated that CMS hasn’t yet issued its final version of the manual. It will be out “shortly,” CMS’s Roxanne Dupert-Frank pledged in the forum.

• NOE and NOTR submission. In the FY 2015 proposed rule, CMS proposes to require hospices to file both the notice of election (NOE) and the new notice of termination/revocation (NOTR) within three calendar days of admission/discharge. This deadline will be challenging given that the forms have to be manually entered via DDE, said Jennifer Handel with Hospice of Michigan in the question-and-answer portion of the forum.

While clinical care is 24/7, “administrative staff are not working 24/7, 365,” Handel told CMS. “It’s administrative staff who would have to manually enter this.”

Due to numerous regulatory changes over the past few years, “we’ve had to continually im-prove our systems to provide data to CMS,” Handel said. “So hopefully CMS can make some minor adjustments to allow for things to be submitted in a more efficient and electronic manner.”

Handel plans to include these concerns in her comments on the proposed rule, she said. Com-ments are due July 1 and the rule is at www.gpo. gov/fdsys/pkg/FR-2014-05-08/pdf/2014-10505.pdf.

• CAHPS. If you qualify for a hospice CAHPS exemption based on small size, you don’t have to participate in a dry run of the patient satisfaction survey during the first quarter of 2015, confirmed CMS’s Debra Dean-Whitaker in the forum.

CMS hasn’t set a deadline for the exemption forms yet, Dean-Whitaker added in response to a question. But the hospice CAHPS website should go up in July, so hospices will likely be able to start submitting exemption forms then, she estimated.

• Quality measures. CMS is proposing no new quality measures for 2015, CMS pointed out in an overview of the fiscal year 2015 proposed hospice payment rule.