Appeals Demonstration Expanded to Home Health and Hospice

On Jan.1, 2016, the Centers for Medicare & Medicaid Services (CMS) launched the Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration to test whether further engagement between Durable Medical Equipment (DME) suppliers and the DME QIC would improve the understanding of the cause of appeal denials and, over time, result in more proper…

CMS Updates Medicare Benefit Policy Manual for Home Health Agencies

The Centers for Medicare & Medicaid (CMS) recently released Transmittal 265/Change Request (CR) 11577 Manual Updates Related to Calendar Year (CY) 2020 Home Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring This CR updates the Medicare Benefit Policy Manual, (Publication 100-02), Chapter 7, to reflect policy changes finalized in the CY 2019 and…

NAHC to Congress: Make Spousal Impoverishment Protection and Money Follows the Person Program Permanent

The National Association for Home Care & Hospice (NAHC) has joined a group of like-minded organizations to urge leaders in both houses of Congress to pass the permanent extension of the Money Follows the Person Program (MFP) and Spousal Impoverishment Protections included in the bipartisan Drug Pricing Reduction and Health and Human Services Improvement Act…

CMS Updates Claims Processing Manual

The Centers for Medicare & Medicaid Services (CMS) has again updated Change Request (CR) 11081 – Home Health (HH) Patient-Driven Groupings Model (PDGM) – Split Implementation through Transmittal 4489. As previously reported, this CR has been updated more than once since its original publication in early 2019 (see previous NAHC Report coverage here and here).…

Open Door Forum Summary: Updates on iQIES Transition Update and Home Health & Hospice

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice, & DME Open Door Forum (ODF) on January 8, 2020.  A summary is provided below, beginning with home health and followed by hospice. HOME HEALTH iQIES Transition CMS indicated in the ODF that it is aware of several issues with the iQIES…

CMS Updates Review Choice Demonstration FAQs to Address PDGM

The Centers for Medicare & Medicaid Services (CMS) has updated the Frequently Asked Questions (FAQs) and the Operational Guide for the Review Choice Demonstration(RCD)to include additional information on how the Patient-Driven Groupings Model (PDGM) will affect the demonstration. CMS updated the Operational Guide in early December  to include instructions for submitting documentation relate to PDGM,…

The Year in Review: Home Health and Hospice in Congress in 2019

Congress Actively Pursued Key Home Health and Hospice Concerns NAHC scored some big victories for patients and providers While 2019 was frequently marked by intense partisan wrangling in Congress, a year-end review by the National Association for Home Care & Hospice (NAHC) shows that elected officials still found time to pursue a number of issues…

CMS Announces TEP for Functional Outcome Measures

The Centers for Medicare & Medicaid Services is accepting applications for a technical expert panel (TEP) to develop functional outcome quality measures for the home health setting. The TEP nomination period closes on January 17, 2020. Project Overview: CMS has contracted with Abt Associates to develop functional outcome quality measures for the home health setting.…

CMS to Host Important Overviews on Direct Contracting Models

The Center for Medicare and Medicaid Innovation (CMMI) will host two events on direct contracting models on January 7 and January 8, intending to provide an overview of the topic and answer questions about the model. In spring 2019, the Centers for Medicare & Medicaid Services (CMS) announced plans to test Direct Contracting models through…

Important Information for all HHA in Review Choice Demonstration under PDGM

For those home health agencies that are part of the Review Choice Demonstration and have selected the Pre-claim Review (PCR) option, the long awaited CMS update confirming that HHAs will need to submit a PCR for each 30-day billing period has been posted.  CMS updated the RCD Operational Guide, Chapter 6, with the following: For…