Home Health & Hospice Week

Changes are coming to the Medicare hospice program, some of them in a rush.

The hospice 2012 final payment rule put in place a change to hospice cap calculation methodology and a new voluntary quality reporting initiative that will become mandatory in 2013 (see Eli's HCW, Vol. XX, No. 28).

By the end of the month, the Centers for Medicare & Medicaid Services plans to issue instructions to its contractors regarding the cap methodology change, a CMS official said in the Aug. 17 home health Open Door Forum. The cap calculation had previously been put on hold during rulemaking. Hospices will have the choice of whether to continue with their current "streamlined" cap calculation or go with a new methodology. Under the new way, the hospice's beneficiary count will be prorated between years the bene is on service.

With the instructions, CMS will issue timelines for making the choice between methodologies, the CMS rep said. Contractors will notify providers via their usual channels.

Meanwhile, the deadline for submitting data for voluntary hospice quality reporting is almost upon providers, but CMS has yet to issue any details about the program. Hospices can expect to see CMS issue a user manual and helpline for the program in November, CMS's Robin Dowell told forum attendees. Data collection will start in January and will reflect data from the fourth quarter of 2011.

CMS will post the information on its new website for the quality reporting requirement at www.cms.gov/ltch-irf-hospice-quality-reporting, Dowell explained.

"We encourage hospices to participate in the voluntary data submission period," Dowell said. The voluntary reporting will be for the structural measure, "Participation in a Quality Assessment and Performance Improvement (QAPI) Program that Includes at Least Three Quality Indicators Related to Patient Care."

When mandatory reporting starts in 2013, CMS will require the QAPI measure and a measure addressing pain management.

Right now CMS is planning to have hospices submit their voluntary data via a web-based interface, Dowell said.

Old way: Finally, the hospice rule changes which hospice physicians can perform the face-toface encounter, pointed out CMS's Lori Anderson in the forum. In last year's hospice final rule, CMS had said the physician conducting the F2F encounter had to be the one recertifying the terminal illness.

New way: Now any hospice physician may conduct the F2F visit, Anderson noted in the forum. CMS had already made this change in its manuals, she added.