Quality Reporting Program Tip Sheets and Training and Education Resources

The Centers for Medicare & Medicaid Services (CMS) has announced that the COVID-19 PR Tip Sheets are now available for the home health quality reporting program (HH QRP) and the hospice quality reporting program (HQRP). The purpose of the tip sheets is to help providers understand the Centers for Medicare & Medicaid Services’ (CMS) public…

Update: Post Payment Medical Review Topics

As previously reported, the Centers for Medicare & Medicaid Services (CMS) authorized the resumption of medical reviews to begin in August. Since the original resumption announcement, hospices and home health agencies have learned that medical reviews administered by the Medicare Administrative Contractors (MACs) will be service-specific post payment reviews. NOTE: Targeted Probe & Educate (TPE)…

Hospice PEPPER Available & Key CMS Updates for Hospice & Home Care in New Open Door Forum

Hospice PEPPER Available The Hospice PEPPER (Program for Evaluating Payment Patterns Electronic Report) is now available. PEPPER is a data report that contains a single hospice’s claims data statistics (obtained from the UB-04 claims submitted to the Medicare Administrative Contractor (MAC)) for areas targeted by CMS as being at risk for improper Medicare payment. Each…

OIG: CMS Could Save Money Reviewing Home Health Claims With Visits Slightly Above LUPA

The Centers for Medicare & Medicaid Services (CMS) could have saved $192 million by targeting home health claims for review with visits slightly above the threshold that triggers a higher Medicare payment, according to a new report from the Office of Inspector General (OIG) of the Department of Health & Human Services. Home health agencies…

Home Health & Hospice Providers: Quality Reporting Resumption and Letters of Noncompliance

NAHC Report wants to remind both hospice and home health providers that quality data reporting  resumed July 1, 2020. For three calendar quarters – October 1, 2019 through June 30, 2020 – the Centers for Medicare & Medicaid Services (CMS) provided an exception for hospice and home health providers from submitting quality data due to…

CMS Directs Release of PEPPER

The annual release of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for all provider types was put on hold by the Centers for Medicare & Medicaid Services (CMS) at the beginning of the current Public Health Emergency (PHE).  The hospice PEPPER is usually released in April and the home health PEPPER is usually…

NAHC Analysis of the CY 2021 Home Health Proposed Rule

CY 2021 Home Health Proposed Rule Addresses Payment Rates, Telehealth, Quality Program and Home Infusion Therapy   Late this afternoon the preview of the CY 2021 home health proposed rule, Medicare and Medicaid Programs; CY 2021 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Requirements; and Home Infusion Therapy Services Requirements, was…

ALERT: Quality Reporting Resumes July 1, 2020

Both hospice and home health providers will resume quality data reporting July 1, 2020. For three calendar quarters – October 1, 2019 through June 30, 2020 – the Centers for Medicare & Medicaid Services (CMS) provided an exception for hospice and home health providers from submitting quality data due to the current Public Health Emergency…

NAHC Comments on CMS’ Interim Final Rule in Response to COVID-19 Pandemic

The National Association or Home Care & Hospice submitted comments on the Centers for Medicare & Medicaid Services (CMS) Interim Final Rule with Comments (IFC) issued March 30, 2020 in response to the COVID -19 pandemic. Below is a summary issues and recommendations related to home health agencies (HHA) and hospice. HOME HEALTH Homebound Status Under…

CMS Updates COVID-19 Waivers

Late on Friday, May 8, 2020, the Centers for Medicare & Medicaid Services (CMS) updated its COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers document with welcome changes for home health agencies and hospices.  CMS expanded the types of therapists able to perform the initial and comprehensive assessment for all home health patients to…