Home Health & Hospice Week

Plus: Don’t lollygag on viewing Compare preview reports.

With less than nine months to go until the Patient-Driven Groupings Model takes effect, home health agencies are anxious to kick their preparation into high gear. Soon they’ll be able to take their prep to the next level with more detailed PDGM operational instructions.

The Centers for Medicare & Medicaid Services issued a “down payment” on PDGM instructions with Change Request 11081, issued Feb. 1, noted a CMS official in the agency’s April 3 Home Health Open Door forum. That CR focuses heavily on elimination of Requests for Anticipated Payment and implementation of “no-pay RAPs” for newly enrolled HHAs (see Eli’s, HCW, Vol. XXVIII, No. 7).

But by the end of April, CMS should issue another transmittal with a new batch of PDGM billing details, the CMS staffer pledged. The forthcoming transmittal will include detailed pricer logic, among other items.

Watch for: The CR will also include diagnosis coding instructions, the CMS source said. They will answer questions agencies posed after the agency’s Feb. 12 PDGM educational call (see Eli’s HCW, Vol. XXVIII, No. 7).

CMS will issue more PDGM operational transmittals later this year as well, the CMS official told forum attendees.

Other home health topics addressed in the forum include:

Home Health Compare. HHAs can now view their preview reports that contain data that will go up on Home Health Compare July 24, a CMS staffer said.

The clock is ticking to view the reports. Agencies have 60 days to review Home Health Compare Provider Preview Reports and 90 days to review Quality of Patient Care Star Ratings Provider Preview Reports, the CMS source explains. “Providers are encouraged to save a copy of their preview reports for later reference,” she added.

More information is at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/index.html. An updated QoPC star ratings fact sheet and Frequently Asked Question set are at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIHomeHealthStarRatings.html.

CAHPS. The reporting year that will determine your 2021 payments began April 1, a CMS official noted in the forum. HHAs must participate in the monthly survey process through March 31, 2020, to receive their full update for that year.

The HHCAHPS Coordination Team is evaluating survey questions, it says in the CAHPS April quarterly review newsletter. The team has completed nine interviews — five in Raleigh/Durham, North Carolina, and four in Chicago — and will conduct nine more in May, CAHPS contractor RTI says in the one-page newsletter at https://homehealthcahps.org/Portals/0/Newsletter/CTQR_Newsletter_Apr_2019.pdf.