Compliance Monitor (8/5/2024)

The final FY 2025 Hospice Wage Index and Payment Rate Update/Quality Reporting Rule  (CMS-1810-F) was posted on the Federal Register Public Inspection desk on 7/30/2024. The rule should be posted in the Federal Register on 8/6/2024. Regulations in this rule are effective on October 1, 2024, unless otherwise specified. 

Read the CHAP rule summary – https://chapinc.org/blog-news/cms-posts-fy-2025-hospice-wage-index-final-rule/

Wednesday, August 7, 2024, PM at 2:00 PM – 3:00 PM Eastern Time (ET). 

This call provides updated regulatory information for home health, hospice, and DME providers 

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

CMS seeks information for a reevaluation of the Program for Evaluating Payment Patterns Electronic Reports (PEPPERs), Comparative Billing Reports (CBRs), and efforts to improve the effectiveness and accessibility of the programs. CMS seeks responses to questions listed in the “QUESTIONS” section of this Request for Information (RFI). CMS may use the information collected through this RFI to make changes to the design of the program. CMS paused the PEPPER in the Spring to reevaluate. 

DATES: Submit comments through the website listed in the “RESPONSE FORMAT” section by 11:59 pm Eastern on August 19, 2024. 

Access the RFI – https://www.cms.gov/files/document/cbr-pepper-rfi-final-july-2024.pdf 

On July 30, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (CMS-1810-F) that provides updates to the fiscal year (FY) 2025 Hospice Quality Reporting Program (HQRP).  

This rule finalizes new HQRP quality measures; finalizes a new data collection instrument, the Hospice Outcomes and Patient Evaluation (HOPE); summarizes responses to a request for information regarding potential social determinants of health (SDOH) elements; and provides updates on Health Equity activities, future quality measures, and public reporting requirements. The rule also finalizes changes to the Hospice Consumer Assessment of Healthcare Providers and Systems (Hospice CAHPS) Survey.   

Lymphedema Compression Treatment Items: Implementation — Revised 

Learn how to prevent claim denials due to duplicate payments (PDF) for compression bandaging systems. 

Beneficiaries Dually Eligible for Medicare & Medicaid — Revised 

Learn what’s changed (PDF). CMS added information on Qualified Medicare Beneficiary billing prohibitions. 

NEW RESOURCE AVAILABLE: Patient Mood Interview (Patient Health Questionnaire PHQ-2 to 9^©) Video Tutorial 

The Centers for Medicare & Medicaid Services (CMS) is offering a video tutorial for completing D0150, Patient Mood Interview (PHQ-2 to 9) and D0160, Total Severity Score. Within the video, the PHQ-2 to 9 assessment and related coding is demonstrated using excerpts from two patient interviews. 

This resource can be accessed through the Home Health Quality Reporting Program (QRP) Training page. 

DMEPOS: Provider Level Adjustment Codes on Remittance Advice  

Learn about system changes to report DMEPOS provider level adjustment codes on the remittance advice. See the instruction to your Medicare Administrative Contractor (PDF). 

CMS announced additional resources and flexibilities available in response to Hurricane Beryl in Texas. CMS is working closely with the state of Texas to put these flexibilities in place to ensure those affected by this natural disaster have access to the care they need – when they need it most. 

On July 12, 2024, HHS Secretary Xavier Becerra determined that a public health emergency exists in Texas and has existed since July 5, 2024. 

CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by the hurricane. 

More Information: 

• Full news alert 

• Current Emergencies webpage 

• Medicare Claims During Public Health Emergencies webpage 

The CDC  issued this Health Alert Network (HAN) Health Advisory to inform health care providers, laboratory professionals, health care facility administrators, and state, tribal, local, and territorial health departments of a critical shortage of Becton Dickinson  BACTEC™ blood culture media bottles. This shortage has the potential to disrupt patient care by leading to delays in diagnosis, misdiagnosis, or other challenges in the clinical management of patients with certain infectious diseases. Health care providers, laboratory professionals, health care facility administrators, and state, tribal, local, and territorial health departments affected by this shortage should immediately begin to assess their situations and develop plans and options to mitigate the potential impact of the shortage on patient care. 

Recommendations: 

• Implement practices to optimize the use of blood cultures at your facility 

• Take steps to prevent blood culture contamination 

• Ensure that the appropriate volume is collected when collecting blood for culture 

• Determine the type of blood culture bottles your laboratory or facility uses and whether this shortage will impact you 

• If your laboratory or facility will be impacted by the bottle shortage, determine whether you have alternative options for blood cultures 

• Monitor current and future supplies of blood culture bottles at your laboratory or facility and report any potential shortages or interruptions to the FDA at deviceshortages@fda.hhs.gov 

• If your facility will be impacted by the bottle shortage, convene a group of local laboratory and clinical experts to determine how a limited supply of blood culture bottles will be prioritized for use in your facility 

See the full Health Advisory for more information.

New Non-Group Health Plan (NGHP) Medicare Secondary Payer (MSP) Beneficiary Reference Guide is Now Available 

A new reference guide intended to provide Medicare beneficiaries with a reference manual to help them navigate the Medicare conditional payment recovery process is now available in the Download section of the Medicare’s Recovery Process page on CMS.gov