CMS Updates Providers on PDGM and Quality Reporting Program

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice & DME Open Door Forum yesterday where CMS representatives provided information on the new Home Health Patient Driven Grouping Model (PDGM), the home health quality reporting program and the Hospice Quality Reporting Program.  A summary of the information shared is below. Home…

Updates to Emergency Preparedness Requirements

The CMS Quality, Safety and Oversight Group (QSO) recently released a memo to state survey agency directors, Emergency Preparedness- Updates to Appendix Z of the State Operations Manual (SOM), notifying them that  emerging infectious diseases have been added to the definition of all-hazards approach, and there are new Home Health Agency (HHA) citations and clarifications…

CMS Issues Instructions for PDGM Claims Processing

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 11081, which provides claim processing  instructions to the Medicare Administrative Contractors ( MACs) that will be necessary to process home health claims with the implementation of the Patient Driven Groupings Model (PDGM). The PDGM will assign 30-day periods of care into one of…

Home Health Compare Updated

The January 2019 quarterly Home Health (HH) Compare refresh, including new quality measure results based on data submitted to CMS, is now available on the HH Compare Site. In addition to the HH QRP measures that have displayed on Home Health Compare previously, the following four new quality measures are newly reported on HH Compare:…

The Role of the Physician Assistant and Nurse Practitioner in Home Health and Hospice

Beginning January 1, 2019, Medicare hospice patients could begin choosing physician assistants (PA) as their attending physician.  However, the benefit of this allowance is not fully realized as one of the Medicare Hospice Conditions of Participation (CoP) prevents these practitioners from fully fulfilling the role of the attending physician for hospice patients.  Questions providers have…

Home Health Billing Requirements – A Reminder

As previously reported on December 15, 2018, there are new billing requirements for all home health agencies beginning January 1, 2019.  Specifically, Change Request 10782, requires that home health agencies put value code 85 on all claims, not just rural claims.  CMS clarified this in a Home Health, Hospice & DME/Quality Open Door Forum on…

Civil Money Penalties Now Applicable to Home Health Agencies

The Centers for Medicare & Medicaid Services (CMS), at NAHC’s urging,, suspended civil money penalties (CMP) that could be incurred by a home health agency during a Medicare survey until January 13, 2019.  This date recently passed making it possible for surveyors to now apply the penalties. CMS may impose a civil money penalty against…

Home Health Agency Provider Enrollment Moratoria Expires

The Centers for Medicare & Medicaid Services (CMS) posted the following on its web site announcing the expiration the Medicare Provider Enrolment Moratoria, which includes those states where a moratorium had been issued for new home health agencies (HHAs). “As of January 30, 2019, there are no active Medicare Provider Enrollment Moratoria in any State…

Home Health & Hospice Quality MATTERS: Forthcoming 2-Day Home Health QRP Training and Hospice Quality Reporting Reminders

HOME HEALTH Home Health QRP Provider In-Person Training Event March 5 and 6, 2019 — REGISTRATION OPEN:  The Centers for Medicare & Medicaid Services (CMS) will be hosting a 2-day Home Heath (HH) Quality Reporting Program (QRP) in-person ‘Train the Trainer’ event for providers on March 5 and 6, 2019, at the Lord Baltimore Hotel, 20…

Office of Inspector General Adds New Items to Home Health Work Plan

The Office of Inspector General (OIG) work planning  is dynamic and adjustments are made throughout the year to meet priorities and to anticipate and respond to emerging issues. A Work Plan was developed and is available to the public.  It is updated monthly with new issues.  In January 2019, there are two new issues of…