April Insights and Critical Updates
CHAP is always seeking resources and insights to enhance the knowledge of partners and customers. Today, we share a recent federal information update.
Hospice Updates
Hospice Requirement for Certifying Physicians to Enroll in or Opt-Out of Medicare: Delayed until June 3
CMS updated this message on April 25, because we delayed the effective date until June 3, 2024.
CMS delayed the date that physicians who certify hospice services must enroll in or opt-out of Medicare until June 3. CMS will deny hospice claims if the certifying physician isn’t in our PECOS hospice ordering and referring files by then.
More Information:
- Hospice Certifying Enrollment Q&A (PDF)
- Hospice Claims Edits for Certifying Physicians (PDF) MLN Matters Article
- FY 2024 Hospice final rule
Updated HIS Manual V3.02 is now available
The updates include an extension of the document’s expiration date and several minor edits and date corrections. The updated documents include the HIS Manual V3.02, HIS-Admission V3.02, HIS-Discharge V3.02. The HIS Manual Change Table V3.01 to V3.02 will provide details. These can all be found in the Downloads section of the HIS page.
CMS Q&A resource: https://www.cms.gov/files/document/hospice-certifying-enrollment-faqs.pdf
Home Health Updates
CMS finalizes the Medicaid Access Rule (CMS 2442-F)
The 80/20 provision in the Medicaid Access Rule mandates that 80% of Medicaid payments for personal care, homemaker, and home health aide services be spent on compensation for direct care workers.
Review the final rule on the Federal Register Public Inspection Desk – Medicaid Program; Ensuring Access to Medicaid Services.
IQIES ALERT
There is a new location for accessing the Patient Assessment Change Request Forms effective immediately. The Change Request Forms for MDS, OASIS, IRF, LTCH, and Hospice can be found at this location: https://iqies.cms.gov/iqies/help.
Please note that State OASIS and State RAI/MDS Coordinators must submit completed and signed forms to the iQIES Service Center by Certified Mail through the US Postal Service Center.
All Change Request Forms will be retired on the QTSO website. Please dispose of any existing hard or electronic copies containing the old address: 1401 50th St. Suite 200.
If you have any questions or concerns, please contact the iQIES Service Center by email: iqies@cms.hhs.gov or by phone: (800) 339-9313. Or to create a new ticket online, track an existing ticket, or recover your HARP password account, please use the CCSQ Support Central: Self-Service Portal.
Care Compare Quarterly Refresh – April 2024
The April 2024 quarterly refresh for the Home Health Quality Reporting Program is now available on Care Compare. For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will be based on the standard number of quarters.
NOW AVAILABLE- Updated Quarterly OASIS Q&As
The April 2023 CMS OASIS Quarterly Q&A’s are available in the OASIS Quarterly Q&As section of the CMS QTSO webpage, https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals .
DMEPOS Updates
DMEPOS Fee Schedule: April 2024 Quarterly Update — Revised
Learn what’s changed (PDF). CMS added 4 HCPCS Level II codes.
All Providers Updates
ONC-Advancing Health Equity by Design and Health Information Technology: Proposed Approach, Invitation for Public Input, and Call to Action
ONC invites stakeholder feedback on the proposed Health equity by design (HEBD) approach described in this discussion draft and information and examples regarding specific actions and tools that you and others are building and using to support health equity by design locally, regionally, or nationally. We solicit feedback from all stakeholders, including, but not limited to, health care providers, health information networks or exchanges, health information technology users and developers, and individuals and communities, and across the health and human services continuum. This discussion draft identifies questions for feedback at various points and collects and repeats them in a section at the end for your convenience. Feedback is due Monday June 10 at 11:59:59pm ET. The information and feedback you share will help ONC further develop and refine this proposed approach before issuing a final version.
https://www.healthit.gov/sites/default/files/2024-04/ONC-HEBD-Concept-Paper_508.pdf
Quality in Motion: Acting on the CMS National Quality Strategy
Quality in Motion: Acting on the CMS National Quality Strategy is CMS’s latest update to the 2022 National Quality Strategy, which was launched to improve the quality and safety of health care for everyone, focusing on those from underserved and under-resourced communities. In the action plan, you will learn how CMS is putting quality-focused goals into motion in four priority areas:
- Outcomes and Alignment
- Equity and Engagement
- Safety and Resiliency
- Interoperability and Scientific Advancement
The new action plan includes a call for payers to improve quality in high-priority clinical areas and reduce provider burden by implementing the Universal Foundation, including the newly published hospital, maternity care, and post-acute care/long-term care add-on sets.
Read Quality in Motion here: https://www.cms.gov/files/document/quality-motion-cms-national-quality-strategy.pdf
Comprehensive Error Rate Testing Program: Reduced Sample Size Starting with Reporting Year 2025
CMS will permanently reduce the Comprehensive Error Rate Testing (CERT) program sample size starting with reporting year (RY) 2025. The sample size for improper payment measurement review will decrease from 50,000 to 37,500 claims annually.
If the CERT Review Contractor completes the RY 2025 review but removes your claim from the sample, they’ll send you a letter.
Your Medicare Administrative Contractor will:
- Adjust the claim if required to reflect the correct codes and payment
- Pay or collect if needed
FDA – Home as a Health Care Hub
The FDA announced a new initiative aimed to help reimagine the home environment as an integral part of the health care system. The Home as a Health Care Hub is intended to enable solutions that seamlessly integrate medical devices and health care, prevention and wellness into people’s lives and may:
- Help medical device developers consider novel design approaches.
- Aid providers to consider opportunities to extend care options and educate patients.
- Generate discussions on value-based care paradigms.
- Open opportunities to bring clinical trials and other evidence generation processes to underrepresented communities.
This new initiative is part of the FDA’s ongoing commitment to advancing health equity and helping people to get the care they need, when they need it. The FDA is collaborating with patient groups, health care providers, the medical device industry, and housing experts to build the Home as a Health Care Hub and we will keep the public informed as additional information becomes available.
OCR Health Equity Factsheet
OCR is working to advance health equity through its rulemaking and enforcement activities, both of which allow OCR to effectuate and enforce standards of the law to prevent non-discrimination and advance fair, just and equal treatment in Federally funded health care programs and activities.
https://www.hhs.gov/about/news/2024/04/01/ocr-health-equity-fact-sheet.html