Compliance Monitor (06/02/2025)
Your source for federal updates
June 2025 Compliance Activity
| FY 2026 Proposed Hospice Payment Update Rule June 10, 2025 | Comments for the FY 2026 Proposed Hospice Payment Update Rule are due June 10, 2025. Instructions for submitting comments appear in the beginning of the rule. |
| CMS Proposed Home Health Payment Update Rule (NPRM) Expected posting in late June – early July | Annual CY issuance May include proposed regulatory information not included in the FY hospice payment update proposed rule Subscribe to the Federal Register for emails of newly posted regulations. The selection of content can be customized. Link to subscribe is listed on the following webpage: https://www.federalregister.gov/documents/current Will first appear on the Federal Register Public Inspection Desk https://www.federalregister.gov/pu blic-inspection/current Will move over to the Federal Register within 7 days of initial posting https://www.federalregister.gov/do cuments/current |
| Transition to All-Payer OASIS Data Collection and Submission July 1, 2025 | Collect and submit OASIS data for all patients with any pay source who are not exempt from OASIS data collection and who begin receiving home health care services with an OASIS SOC M0090 date on or after July 1, 2025 https://www.cms.gov/files/document/oasisall-payer-transition-fact-sheetdec-2024.pdf |
| 1557 compliance date correction July 5, 2025 | Covered entities are required to distribute a new notice to inform individuals of the availability of non-English assistance. The new notice replaces the old foreign language “taglines” that were required under previous versions of the Section 1557 regulations. Some employers have already redesigned their notices to meet this requirement when they met earlier Section 1557 notice deadlines in the fall. |
Top Items
Medicare Advantage Reform Act Introduced to Congress
Rep. David Schweikert (R-Ariz.) recently introduced the Medicare Advantage Reform Act. If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage (MA).
A key provision of the bill is a proposed requirement that MA plans pay for hospice care.
CMS Increasing Oversight on States Illegally Using Federal Medicaid Funding for Health Care for Illegal Immigrants
The Centers for Medicare & Medicaid Services (CMS) announced today increased federal oversight to stop states from misusing federal Medicaid dollars to cover health care for individuals who are in the country illegally. Under federal law, federal Medicaid funding is generally only available for emergency medical services for noncitizens with unsatisfactory immigration status who would otherwise be Medicaid-eligible, but some states have pushed the boundaries, putting taxpayers on the hook for benefits that are not allowed.
The letter to states is available at: https://www.cms.gov/files/document/open-borders-eo-notification-states.pdf
Hospice Provider Updates
MA Reform Act Bill Introduced to Congress
Rep. David Schweikert (R-Arizona) has introduced the Medicare Advantage Reform Act, which among other provisions would require health plans to pay for hospice care.
If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage program. It would mandate capitated payment models, change risk adjustment methodologies, create new exemptions for physician self-referrals, among other provisions
https://www.congress.gov/bill/119th-congress/house-bill/3467/text
NEW RESOURCE AVAILABLE: Getting Started with the Hospice Quality Reporting Program and Public Reporting
The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training that provides an introduction to the Hospice Quality Reporting Program (HQRP) and its quality measures. The course is intended to help hospices ensure accuracy and compliance in meeting program requirements, understand their role in public reporting, and track their own metrics to improve quality.
- To access the courses, select the following link: Getting Started with the Hospice Quality Reporting Program and Public Reporting
HQRP Public Reporting Quarterly Refresh – May 2025
The May 2025 quarterly refresh for the Hospice Quality Reporting Program is now available on the Compare tool on Medicare.gov.
In this refresh, HIS measure scores are based on HIS data submitted by hospices from Quarter 3, 2023 through Quarter 2, 2024. CAHPS measure scores are based on CAHPS data submitted from Quarter 3, 2022 through Quarter 2, 2024. CAHPS Star Ratings are calculated based on data from Quarter 2, 2022 through Quarter 1, 2024. The claims-based measures reflect claims data collected from Quarter 1, 2022 through Quarter 4, 2023.
For additional information, please see the FY2025 Hospice Wage Index Final Rule at https://www.cms.gov/Center/Provider-Type/Hospice-Center.
Hospice Preview Reports for the August 2025 Refresh – NOW AVAILABLE IN QIES
Providers can now access the latest Provider Preview Reports via the Certification and Survey Provider Enhanced Reports (CASPER) application. These reports contain provider performance scores for quality measures, which will be published on the compare tool on Medicare.gov and the Provider Data Catalog (PDC) during the August 2025 refresh.
In the Provider Preview Reports, HIS measure scores are based on HIS data submitted by hospices from Quarter 4, 2023 through Quarter 3, 2024. CAHPS measure scores are based on CAHPS data submitted from Quarter 4, 2022 through Quarter 3, 2024. CAHPS Star Ratings are calculated based on data from Quarter 4, 2022 through Quarter 3, 2024. The claims-based measures reflect claims data collected from Quarter 1, 2022 through Quarter 4, 2023.
Once released in CASPER, providers will have 30 days during which to review their quality measure results. The preview period for the latest Provider Preview Report lasts from May 21, 2025 to June 20, 2025. Although the actual “preview period” is 30 days, the reports will continue to be available for another 30 days, or a total of 60 days. CMS encourages providers to download and save their Hospice Provider Preview Reports for future reference, as they will no longer be available in CASPER after this 60-day period.
Learn more about the Provider Preview Report (HIS and Claims-based measures) here and about the CAHPS Preview Report here. Hospice QRP Key Dates for Providers can be found here. The 3rd Edition HQRP Public Reporting Tip Sheet is available here
All Providers Updates
CMS Rolls Out Aggressive Strategy to Enhance and Accelerate Medicare Advantage Audits
CMS announced a significant expansion of its auditing efforts for Medicare Advantage (MA) plans. Beginning immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.
CMS conducts Risk Adjustment Data Validation (RADV) audits to confirm that diagnoses used for payment are supported by medical records. Currently, CMS is several years behind in completing these audits. To address this backlog, the Trump Administration has introduced a plan to complete all remaining RADV audits for PY 2018 to PY 2024 by early 2026.
Educational Opportunities
CMS QualCon25!
This year’s theme — “Make America Healthy: Improving Health Outcomes Through Prevention, Quality, and Safety” — sets the stage for an inspiring and action-oriented gathering of healthcare leaders, advocates, and innovators.
Don’t Miss This Opportunity to:
- Hear directly from CMS Administrator Dr. Mehmet Oz about CMS’ mission to improve health outcomes
- Dive into powerful conference tracks tackling challenges in prevention, quality, tech, innovation, and more
- Connect with peers and leaders from across the healthcare spectrum — including patients, providers, researchers, and policymakers
Event Details:
Dates: July 1–2, 2025
Location: Hilton Baltimore Inner Harbor, Baltimore, MD
Lodging: Special conference rates available at Hilton and Marriott Inner Harbor
CMS #QualCon25 Registration is Now OPEN
Registration is now open for the 2025 CMS Quality Conference! Join us as we Make America Healthy: Improving Health Outcomes Through Prevention, Quality, & Safety.
Conference Highlights:
- Dates: July 1-2, 2025
- Location: Hilton Baltimore Inner Harbor
- Featured Speaker: Dr. Mehmet Oz, CMS Administrator
Hotel Options:
- Hilton Baltimore Inner Harbor: $150/night
- Baltimore Marriott Inner Harbor at Camden Yards: $150/night
CMS Resources
CMS Fast Facts: Annual Update
CMS updated the CMS Fast Facts to include data for 2022–2025. Use this quick reference statistical summary for information on Medicare and Medicaid enrollment, utilization, expenditures, and Medicare provider counts.