DMEPOS Updates

The Center for Program Integrity joined the call to provide an update on the prior authorization requirement changes to DME. In February, CMS released updated guidance in response to OIG reports and integrity efforts for improper payment. CMS is preparing guidance for instances when access to the DME listed in the update is urgently needed and the required two-day expedited review would delay care and risk the health or life of the beneficiary. Additional information on the DME updates is available here. The changes will be phased in during three stages. On October 10, 2022, the final phase of implementation will commence with all state which have not yet made the prior authorization transition.

Home Health Value Based Purchasing (HHVBP)

The implementation of the expanded Home Health Value Based Purchasing is less that 100 days away.

Due to a technical error some home health stakeholders could not to enter a webinar hosted by the CMS home health value-based purchasing team on August 25. To correct this error CMS will be hosting an encore live webinar with the same content on October 11^th from 2:00 pm ET – 3:00 pm ET. The webinar will introduce the two (2) types of expanded HHVBP Model performance feedback reports Interim Performance Report (IPR) and Annual Performance Report (APR). Register Here.

Home Health Quality Reporting Program

Home Health Care Compare will refresh in October. The OASIS and CAHPS measure will be updated as part of this refresh however, the claims-based measures will not be refreshed. Preview reports for this October refresh were made available in July.

CMS shared that they recently completed a virtual training program for OASIS-E implementation and the resources from that training is available on the “Home Health Quality Reporting Training” webpage.

Home Health CAHPS Survey Update

Preview Reports reflecting results from the Home Health Care CAHPS (HHCAHPS) Survey from April 2021 through March 2022 (Q2,2021-Q1,2022) are now available on the HHCAPHS website under the “For HHAs” tab. These same data will be updated on Medicare’s compare tool on in late October 2022. The Preview Reports present the publicly reported results, which also include star ratings for those agencies with data for 40 or more patient surveys in the 4-quarter reporting period.

The October 2022 Home Health CAPHS Quarterly Newsletter will be released on October 3, 2022. These are a good source of information and a fun way to find out more about the survey process. In this edition, there will be an update on the revised survey cover letters which includes less text and is more visually engaging as well as reminders for both home health agencies and survey vendors.

The next data submission deadline for Q2 CY2022 Home Health CAPHS data is Thursday, October 20, 2022.  To ensure that files can be accepted by the deadline at 11:59 PM Eastern Time on October 20, 2022, you must submit all Quarter 2 files on or before Wednesday, October 19, 2022. Since CMS will not accept any files after the data submission deadline, make sure you check your data submission reports to verify that all of your submitted files were accepted. And, correct and re-submit all files before the data submission deadline.

The CY 2024 participation exemption request form is up on HHCAPHS website. Agencies who meet the criteria for exemption have until March 31, 2023 to submit the form. Exemption is available to agencies with 59 or fewer HHCAHPS-survey eligible patients between April 1, 2021 and March 31, 2022. The team reminded participants that home health agencies currently participating in HHCAPS should not stop participating in survey if they currently have a small enough number of patients to be eligible for exemption. Home health agencies need to continue for the entire survey period through March 31, 2023.

Hospice Quality Reporting Program

CMS staff shared several public reporting updates for the hospice quality reproting program. In November 2022, Hospice Care Compare will be refreshed to include updates to the Hospice Item Set data. Provider preview reports were issued August 17^th, CMS staff encourage hospices to go into CASPER and download the reports as they will no longer be available after 60 days.

Testing on the HOPE patient assessment is continuing. The draft assessment tool is in its final phase with the ongoing beta test collection. Abt Associates, the CMS contractor leading the collect and feedback effort, will provide a final version for CMS in the next year.

On Wednesday, September 28, 1:30-2:30pm ET, the Centers for Medicare & Medicaid Services (CMS) will host a webinar to share updates for the Hospice Quality Reporting Program. During this webinar, CMS staff and subject matter experts from Abt Associates will provide information on the Fiscal Year (FY) 2023 Hospice Final Rule, recent Public Reporting activity, and updates related to HQRP. CMS will also answer questions at the end of the webinar, as time allows. Click here to register. Several new updated resource – user manual and change table downloads of current measure letter

New resources for hospices and the general public have also been issued since the previous open-door forums.

Third Edition HQRP Public Reporting Tip Sheet: The Third Edition HQRP Public Reporting Tip Sheet is meant to support providers understand public reporting for the Hospice Quality Reporting Program in the midst of the COVID-19 Public Health Emergency (PHE). This tip sheet provides updates to the Second Edition HQRP Public Reporting Tip Sheet. The Third Edition HQRP Public Reporting Tip Sheet is available under Provider Toolkit on the HQRP Requirements and Best Practices page.

Getting Started with Hospice CASPER Quality Measure Reports: This fact sheet contains information about the two Certification and Survey Provider Enhanced Reporting (CASPER) Quality Measure (QM) reports available to hospice providers. Additionally, this fact sheet includes one potential model hospices could employ to use the QM reports for quality improvement.

HQRP: Hospice Care Index Measure (HCI) Informational Video. CMS released a video describing the Hospice Care Index (HCI) measure. This video provides an overview of the new HCI claims-based measure, which combines several quality indicators into a single index score that patients and families can readily use to compare their hospice options. With the inclusion of this measure, the Medicare Hospice Quality Reporting Program offers patients, families, and caregivers a more comprehensive and holistic view when making decisions about hospice care.

Hospice Quality Reporting Program (HQRP) Explanatory Video. CMS released a new video resource providing an overview of the HQRP. The video introduces the purpose of the HQRP, how data is collected for use in HQRP, and the quality measures included in HQRP.

Acronym List: This revised resource is an updated list of acronyms commonly used throughout HQRP training materials and presentations. CMS encourages providers to download and/or print this acronym list to have available as they review resources in the Training and Education Libraries.

In October, Swingtech will issue a quarterly informational email for hospice providers on the HQRP. This outreach communication can be found on the HQRP Requirements and Best Practices webpage in the downloads section. If providers would like to receive Swingtech’s quarterly emails (or update their email) they can email QRPHelp@swingtech.com. Providers should include their facility name and CMS Certification Number (CCN) along with any requested updates

Additional Audience Questions

One caller asked when the videos from the OASIS-E training would be posted to the CMS website, noting that there were less than 100 days until implementation. CMS shared that there is a 30-45 day turn around for posting live webinars to the website but that an announcement will be issued when the videos become available.

Another caller asked for confirmation that home health agencies will get provider preview reports containing two new measures to be publicly published on Home Health Care Compare in 2023. Per the CY2022 Final Home Health rule, in CY2023, CMS will replace two hospitalization measures – Acute Care Hospitalization During the First 60 days of Home Health and Emergency Department Use without Hospitalization During the first 60-days of home health—with a Home Health Within Stay Potentially Preventable Hospitalization (PPH) measure. The PPH measure is designed to include unplanned hospitalizations CMS confirmed that the new measure will be available in the provider preview reports.

The individual asked a follow up question on whether the previously used measures will be removed from Home Health Care Compare at same time that the PPH. CMS was not able to confirm at this time if the other measures would be removed.