Compliance Monitor (7/3/2024)

CHAP is always seeking resources and insights to enhance the knowledge of partners and customers. 

Be sure to download CHAP’s Compliance calendars for home health and hospice. 

Hospice Updates

Hospice HQRP Outreach Email – June 2024  

CMS has posted the June 2024 Hospice Quality Reporting Program (HQRP) – Important Reminders and Updates 

Period of Enhanced Oversight for New Hospices in Arizona, California, Nevada, & Texas — Revised  

Learn what’s changed (PDF). CMS clarified the period of enhanced oversight for reactivating hospices. 

Quality Reporting Program: Non-Compliance Letters for FY 2025 APU 

The Centers for Medicare & Medicaid Services (CMS) is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2023, which will affect their FY 2025 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs) and were placed into facilities’ CASPER folders in QIES, for Hospices and into facilities’ My Reports folders in the Internet Quality Improvement and Evaluation System (iQIES), for IRFs, LTCHs and SNFs, on July 03, 2024. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 14, 2024.  

If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the appropriate QRP webpage: 

Hospice Quality Reporting Reconsideration Requests 

Home Health Updates

CY 2025 Home Health Prospective Payment System Proposed Rule 

Learn about the CY 2025 Home Health Prospective Payment System proposed rule.  

CHAP’s CY 2025 Home Health Prospective Payment System Proposed Rule Summary 

Expanded Home Health Value-Based Purchasing (HHVBP) Model – June 2024 Newsletter 

This newsletter contains information for home health agencies (HHAs) related to the expanded Home Health Value-Based Purchasing (HHVBP) Model, including Model highlights, training updates, new insights, reminders, resources, and contact information. The Centers for Medicare & Medicaid Services (CMS) and the PAC Training Team will release these newsletters on a quarterly basis. 

OIG – Common Billing Errors in Home Health Care 

The OIG knows the majority of Texas Medicaid home care professionals take pride in their work and deliver excellent care to their clients. However, the OIG often sees the same errors repeated across the system through its audits, inspections, reviews and investigations. Problems may also be revealed through the OIG’s data-driven initiatives that examine claims and flag unusual billing patterns, or they may arise from potential suspicious behavior reported by another provider or Medicaid client. Whether the violations are accidental or intentional, it is the OIG’s job to verify that work billed to Medicaid was performed, necessary and met the profession’s standard of care. 

Read more… 

DME Updates

DMEPOS Fee Schedule: July 2024 Quarterly Update 

Your Medicare Administrative Contractor will adjust claims for code E2298 with dates of service on or after April 1, 2024, that you bring to their attention. 

All Provider Updates

The next Home Health, Hospice & DME Open Door Forum is scheduled for Tuesday, July 9, 2024, PM at 2:00 PM – 3:00 PM Eastern Time (ET). 

View the call agenda at https://www.cms.gov/files/document/tuesday-july-9-2024-agenda-home-health-hospital-dme-open-door-forum.pdf 

Register in advance for this webinar: https://cms.zoomgov.com/webinar/register/WN_vfsU5LSKR3atiW9T_AhrDg 

2024 Virtual National Provider Compliance Conference — August 7 & 8  

Wednesday, August 7 and Thursday, August 8, 2024, from 12–4 pm ET 

Register for this conference by July 31, 2024. 

Target audience: Anyone who processes Medicare Part A and Part B, home health, hospice, or DME claims, including physicians, non-physician practitioners, billing specialists, suppliers, associations, coders, and medical review contractors. 

HHS Finalizes Rule to Discourage Healthcare Providers from Information Blocking 

The Department of Health and Human Services (HHS) has finalized a rule establishing disincentives for healthcare providers found to have engaged in information blocking. Information blocking refers to a practice likely to interfere with access, exchange, or use of electronic health information, except when required or permitted by law. This rule aims to enhance patient access to electronic health information and ensure greater transparency and interoperability across the healthcare system by imposing disincentives, such as potential civil monetary penalties and other enforcement actions. See the HHS fact sheet for additional details about the final rule. Please reach out to regulatory@nhpco.org with any questions. 

Reminder: Medicare QIO Kepro is Becoming Acentra Health 

Kepro, the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for 29 states, including Florida, has recently announced its transition to Acentra Health. As a BFCC-QIO, Kepro/Acentra Health assists Medicare beneficiaries, along with their families and caregivers, in filing quality-of-care complaints and appeals related to issues such as hospital discharge and termination of skilled services. Additionally, they provide immediate advocacy services to promptly address medical concerns. 

Throughout the rebranding process, all services, including case reviews, will continue seamlessly. While Medicare providers are encouraged to update beneficiary notices such as the Important Message from Medicare (IM) and the Notice of Medicare Non-Coverage (NOMNC) by replacing “Kepro” with “Acentra Health,” notices with the QIO name “Kepro” will still be accepted and validated. 

The transition to Acentra Health is expected to be completed by Fall 2024. Read More 

CMS Updates Stay of Enrollment 

The CY 2024 Physician Fee Schedule (PFS) Final Rule contains provisions about Medicare provider enrollment. One of these provisions is the creation of a new provider enrollment status labeled a “stay of enrollment.” 

Updated information – CMS revised the effective and implementation dates and the web address of CR 13449. 

MLN Stay of Enrollment article