Home Health & Hospice Week

Plus: Get those comments in before it’s too late.

School may be out for summer, but home health and hospice agencies will have a lot of homework in the coming weeks and months.

For one, the Centers for Medicare & Medicaid Services is changing the hospitalization quality measure for the Home Health Quality Reporting Program, which will affect star ratings starting with the October Care Compare refresh, CMS’ Jermama Keys reminded HHAs in the agency’s May 22 Open Door Forum. Preview reports for that update will hit agencies’ iQIES folders in July, Keys noted.

Recap: CMS finalized in its 2024 home health final rule that it would replace the claims-based Acute Care Hospitalization (ACH) During the First 60 Days of Home Health Use and the Emergency Department Use without Hospitalization During the First 60 Days of Home Health measures with the claims-based the Potentially Preventable Hospitalization (PPH) measure. That measure contributes to the star rating, Keys pointed out.

CMS will both post its new star rating methodology and hold a learning event in June, Keys told forum attendees.

Other home health and hospice issues addressed in the forum include:

• Hospice rule comments. Hospices have only a few more days to submit comments on the 2025 proposed hospice rule. Comments are due May 28, Keys mentioned in the forum.

Recap: According to the rule released on March 28, CMS plans to increase hospice payment rates by 2.6 percent; implement the HOPE data collection tool “on or after” Oct. 1, 2025; and revise election statement language, among other provisions (see HHHW by AAPC, Vol. XXXIII, No. 12).

The rule also proposes changes to the CAHPS survey, Keys pointed out to an attendee who asked for revisions to make the survey shorter and easier for elderly patients to fill out.

• OASIS risk adjustment. CMS may have issued the new OASIS-E1 tool and Guidance Manual (see HHHW by AAPC, Vol. XXXIII, No. 17), but HHAs and their vendors are still waiting on associated risk adjustment changes. CMS says it will update HHQRP risk adjustment in January, and providers and vendors would like to know the technical specifications of that in advance this time, a participant urged in the question-and-answer portion of the call.

CMS “will take that into consideration,” Keys responded.

• County code edits. Pay attention to the recent Medicare transmittal putting new claims edits into effect for including county codes, or you may face returned claims this fall. “A recent report from the [HHS] Office of Inspector General noted that the county code is incomplete. Medicare systems need to edit to make sure the county code is present on all claims,” explained CMS’ Wil Gehne in the forum.

Change Request 13543 makes that change Gehne pointed out (more CR details are in HHHW by AAPC, Vol. XXXIII, No. 13). “Effective October 1, 2024, you must report county codes (value code 85) on all home health claims with type of bill 032x,” CMS says in its latest MLN Matters newsletter. The 21-page CR is at www.cms.gov/files/ document/r12577cp.pdf.

• Care Compare hospice refresh. Updated data will go up on Care Compare for hospices this month, Keys highlighted. Hospices will also see preview reports go into their iQIES folders for the next refresh.