Eli's Hospice Insider

Published on Wed Feb 17, 2016 PDF

Take a break from HIS data reporting during QIES break.

Make plans now to avoid data reporting penalties caused by a QIES shut-out in March.

“All Quality Improvement and Evaluation System (QIES) systems will be unavailable from Wednesday, March 16 after 8 pm ET through Monday, March 21, 2016,” the Centers for Medicare & Medicaid Services says in a message to providers.

“This downtime will affect all QIES connectivity and systems.” That includes reporting Hospice Item Set data, stressed CMS’s Mary Best in the Jan. 27 Open Door Forum for hospice providers. Make contingency plans to assure your data is submitted timely despite the system disruption, she urged attendees.

Keep your schedule straight to avoid missing your 30-day Hospice Item Set submission deadline, she urged. HIS submission stats now affect your reimbursement rate. CMS will dock agencies 2 percent if they don’t hit the 70 percent mark in 2016, the 80 percent mark in 2017, and the 90 percent mark in 2018.

CMS hasn’t explicitly stated the reason for the longer-than-usual downtime, a CMS official said in response to a provider question. But it has to do with security compliance, she offered.

You can check on how you’re doing with your HIS submission stats with new reports available via CASPER, noted CMS’s Mary White in the forum. CMS will tell agencies how they’ve stacked up to the 70 percent HIS submission benchmark for HIS assessments completed Oct. 1, 2014 through Sept. 30 2015, and submitted by Oct. 30, 2015, White said.

CMS aims to encourage hospices to use the reports before their 2016 HIS stats determine their payment update for 2018.

Going forward, CMS will issue updated reports quarterly, White added.

Pitfall: The reports will help you ensure that the HIS records you think you are submitting to the QIES system are actually received and accepted, a CMS official said.