CHAP Shares Standards for the Home Infusion Therapy Supplier

The Medicare home infusion therapy (HIT) supplier benefit is a new Medicare Part B benefit established in the 21st Century Cures Act. The new benefit covers the professional services associated with the provision of Part B infusion drugs, such as, nursing services that are furnished in accordance with a plan of care. The services include…

Recommendations and Clarifications for HHAs on the No-Pay RAP

Beginning January 1, 2021, home health agencies (HHAs) will be required to submit a request for anticipated payment (RAP) that will be paid at 0 percent, prior to each claim. The Centers for Medicare & Medicaid Services (CMS) finalized the No-pay RAP policy in the CY 2020 Home Health Prospective Payment System Rate Update rule.…

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…