Hospice Center

• Submit Structural Measure Data for the Hospice Quality Reporting Program (HQRP )by 11:59 PM Eastern time, January 31, 2013
  The deadline for submission of structural measure data for the HQRP is 11:59 PM Eastern time, January 31, 2013. Hospice providers that have not already created a user account and begun structural measure data entry should do so immediately.  The Hospice Final Rule (August 2011) established that this year is a “pay for reporting” year. This means that hospices will receive an APU reduction based on whether or not they report. Your performance level is not a consideration for APU impact. In practical terms, this means that all hospices, regardless of whether or not they have a QAPI program in place, should submit answers to several questions via the data entry website to satisfy this year’s reporting requirements. Providers that fail to meet BOTH of the required HQRP reporting deadlines (1/31/13 for the structural measure; 4/1/13 for the NQF #0209 Pain Measure) will receive a two percentage point reduction in their 2014 Annual Payment Update (APU).
  
  The link to the data entry site is available on the Data Submission portion of the CMS HQRP website , at the bottom of the webpage, under “Related Links.”
• Future Hospice Data Collection:  We are seeking public comments on possible additional data collection on hospice claims, and have an update on revisions to hospice cost reports.  Please see the attached memo Possible Future Hospice Data Collection [PDF, 43KB] and sample claim Phase 4 Hospice Claim Example [ZIP, 75KB] .  
  We ask for your feedback on the suggested data collection by January 31, 2013; please send comments to HospiceData@cms.hhs.gov.  
• CMS-1434-N:  The Centers for Medicare & Medicaid Services (CMS) issued a notice to update the Medicare Hospice Wage Index for fiscal year (FY) 2013.  This notice also provides clarification on additional diagnoses reporting on hospice claims and updates on hospice payment reform and hospice quality reporting. Hospices serving Medicare beneficiaries will see an estimated 0.9 percent increase in their payments for FY 2013. The hospice payment increase is the net result of a 1.6 percent increase in the “hospital market basket” update, which is offset by a 0.7 percent decrease in payments to hospices due to updated wage index data and the fourth year of CMS’ 7-year phase-out of its wage index budget neutrality adjustment factor (BNAF).
• On June 1, 2012, CMS issued CR 7838, entitled “Updates to Caps and Limitations on Hospice Payment”, which moved the cap section of the hospice claims processing manual (IOM 100-04, chapter 11, section 80) to the hospice benefit policy manual (IOM 100-02, chapter 9, new section 90).  CR 7838 also updated the aggregate cap policy to reflect the changes in cap policy which were finalized in the August 4, 2011 Hospice Wage Index Final Rule. 
• The Centers for Medicare & Medicaid Services (CMS) recently issued Change Request (CR) 7675 entitled "Revisions to the Hospice Medicare Summary Notice (MSN)" and CR 7677 entitled "New Hospice Condition Code for Out of Service Area Discharges".   Both CRs will be effective July 1, 2012. 
• Correction to CMS-1355-NR [PDF, 183KB]   (Text Version), "Hospice Wage Index for Fiscal Year 2012", which was published in the Federal Register on May 9, 2011: This Notice of Ruling was corrected to show the correct title, "Hospice Appeals for Review of an Overpayment Determination."  Additionally, this Notice of Ruling was corrected change the effective date of this Notice of Ruling from "April 14, 2011" to "May 9, 2011". (Posted July 22, 2011)
• CMS-1355-R / CMS-1355-NR: Ruling (Issue Date: April 14, 2011; Publication Date: May 9, 2011). CMS issued a Ruling, effective April 14, 2011, establishing CMS policy related to when a hospice challenges the validity of the beneficiary counting methodology in its appeal of an overpayment determination for any hospice cap year ending on or before October 31, 2011. (Posted May, 6 2011)

Medicare FFS e-News Spotlights

• Subscribe now to receive the weekly CMS Medicare FFS Provider e-News for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.