Home Health & Hospice Week

Plus: When will the 2020 rule be out?

For home health providers accustomed to spending their July Fourth holiday perusing next year’s payment and regulatory changes in the annual update proposed rule, this year was a switch. That’s because at press time, the Centers for Medicare & Medicaid Services had yet to issue the Home Health Prospective Payment System proposed rule for 2020.

“Unfortunately right now, as you obviously have noticed, it is not out yet,” a CMS official told a caller asking about the rule in the agency’s July 9 Home Health Open Door Forum. “We expect it to be soon, so stay tuned,” the CMS source added in the question-and-answer portion of the call.

While CMS has yet to publish the rule, which will presumably include final Patient-Driven Groupings Model information, the agency is revealing some details about PDGM’s payment software.

Usually, CMS’s vendor issues a beta test version of the PPS grouper software update about a month before the new version takes effect, a CMS payment official said in the forum. But this year, the agency is giving beta testers extra time to try out the new software. That’s because the grouper will have “entirely new logic” required by PDGM, he noted.

Enrolled beta testers will be able to access the new grouper Aug. 5, the CMS staffer said.

To find out more about beta testing and sign up to be a tester, go to www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/CaseMixGrouperSoftware.html.

Other home health topics addressed in the forum include:

• OASIS Q&As. Watch for CMS to issue the next set of OASIS questions and answers July 16, a CMS official said in the forum. CMS has resumed issuing OASIS Q&As on a quarterly basis, the last set came out in April. To access the Q&As, go to https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals — scroll down to and click on the “OASIS Quarterly Q&As” item.
• Section GG. CMS has issued some new resources to help you get GG coding right, a CMS official pointed out. A 45-minute, four-part online training course covers these topics: Importance of Section GG for Post-Acute Care; Section GG Assessment and Coding Principles; Coding GG0130. Self-Care Items; and Coding GG0170.Mobility Items, CMS notes on its training website. The course is intended for all PAC providers answering the items on their assessment forms.

CMS also has posted four video tutorials on these GG item topics: Coding GG0110. Prior Device Use with Information From Multiple Sources; Decision Tree for Coding Section GG0130. Self-Care and GG0170. Mobility; Coding GG0130B. Oral Hygiene; and Coding GG0170C. Lying to Sitting on side of bed (4:33). The tutorials, “ranging from 4-12 minutes, are designed to provide targeted guidance using simulated patient scenarios,” CMS notes on its website. Again, the tutorials are aimed at all the PAC providers answering these questions.

Both resources are available on CMS’s Home Health Quality Reporting Training page at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Home-Health-Quality-Reporting-Training.html — scroll down to the June 27 and June 7 posts, respec­tively.

• Annual update. If you missed CMS’s June 19 webinar on Achieving a Full APU/Market Basket Increase, you can download the slides from the presentation. The webinar went over data submission requirements and the reconsideration process, among other topics, a CMS staffer noted in the forum. Access the slide presentation in the “Downloads” section of the Home Health Quality Reporting Training page (see web address, above).
• HH Compare. Preview reports and Star Rating preview reports for the October 2019 Home Health Compare refresh are now available in agencies’ CASPER folders. The preview reports had been delayed as CMS worked to align display of the data across Compare sites for other provider types, the National Association for Home Care & Hospice notes.

The October refresh contains star rating data that is updated annually, a CMS official noted in response to a provider question.