Home Health & Hospice Week

Don't rest on your laurels if you're exempt from HHCAHPS for 2012.

The Home Health Consumer Assessment of Healthcare Providers and Systems (CAHPS) program will require an annual exemption, said Lori Teichman with the Centers for Medicare & Medicaid Services in the Jan. 19 Open Door Forum for home care providers. The exemption forms that affect home health agency payments in 2012 were just due Jan. 21. But the forms that will affect 2013 will be available in a few short months on April 1.

If you do not qualify for an exemption for 2013, you must submit CAHPS data starting with April 2011, Teichman told forum attendees.

Remember: To qualify for an exemption, an agency must service 59 or fewer CAHPS survey-eligible patients in the year running from April 1 to March 31. For 2013, agencies will count patients from April 2010 to March 2011, Teichman explained.

If you suspect you won't qualify for the exemption this year and you want to avoid the 2 percent payment reduction, you should hop on CAHPS compliance. "To do so, agencies should go to https://homehealthcahps.org, register for credentials, review the list of approved HHCAHPS vendors, begin their vendor selection process, and authorize a survey vendor so that they may start HHCAHPS in time for the April 2011 sample month," advises the National Association for Home Care & Hospice.

If your referring physicians are telling you they can't get enrolled in PECOS, there's a good reason -- a system backlog. "There is a backlog at the moment," CMS's John Spiegel acknowledged in the forum The PECOS contractor is working to resolve the backlog, Spiegel told a caller.

CMS has announced a delay to edits for physician claims based on the ordering/referring physician being enrolled in PECOS. However, CMS hasn't yet announced a delay for PECOS edits for HHA claims, which are scheduled for July.

Resource: Home care providers reported problems such as physicians falling off the PECOS approved list and physicians receiving a PECOS confirmation, but not appearing on the approved list. Spiegel suggested calling 410-786-5704 or 410-786-5084 to check on such problems.