Eli's Hospice Insider

Published on Tue Oct 13, 2020 PDF

Don’t forget: Your potential referral sources and patients — not to mention competitors — can easily look up whether you are complying with Hospice Quality Reporting Program data reporting requirements.

The Centers for Medicare & Medicaid Services has posted “the list of successful hospices for FY 2021 Hospice QRP,” it says on the HQRP webpage. “These hospices met the CY 2019 hospice quality data reporting requirements that impact FY 2021 payment. Successful hospices receive their full annual payment update (APU).”

A link to the 97-page PDF list is in the “Downloads” section at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/HQRP-Requirements-and-Best-Practices.

Medicaid Hospice Rates For 2021 Posted

Check out Medicaid’s fiscal year 2021 hospice payment rates in a three-page memo at www.medicaid.gov/medicaid/benefits/downloads/medicaid-hospice-rates-ffy-2021.pdf.

Remember, wage index changes that apply to Medicare also affect Medicaid rates, including at a “1-year, 5 percent cap on wage index decreases for impacted counties for FY 2021,” the memo reminds hospices.

Hospices Need COVID-19 Test Help

If you’re having trouble securing COVID-19 testing for your employees, you’re not alone. “With COVID-19 infection rates increasing throughout regions of the U.S. and new testing mandates being imposed at the state and federal level, hospice providers are experiencing difficulty accessing tests and covering costs for their frontline hospice workers,” the National Hospice and Palliative Care Organization says in a release.

NHPCO is asking HHS Secretary Alex Azar for “$500 million in dedicated funding for test kits and rapid point-of-care testing machines,” according to a Sept. 14 letter from the trade group to the HHS Secretary. “This funding would be aimed at providing COVID-19 tests for hospice staff working in patients’ homes, nursing homes, facilities and assisted living facilities,” NHPCO CEO Edo Banach says in the letter.

HHS has started shipping millions of free rapid response COVID-19 tests from Abbot Labs to hospice and home health agencies, as of the end of September, reports the National Association for Home Care & Hospice. But agencies need significantly more testing support to cover their needs.

Beware: Your Wage Index Code May Change Under CBSA Transition

A move to help ease provider burden with the new wage index designations will also complicate billing this year. The Centers for Medicare & Medicaid Services is adopting new Office of Management and Budget categories for wage index areas, and is capping any changes in value at 5 percent in fiscal year 2021 (see Hospice Insider by AAPC, Vol. 13, No. 6).

The problem: Due the transition methodology, “some Core Based Statistical Areas (CBSAs) and statewide rural areas will have more than one wage index value associated with that CBSA or rural area,” CMS says in Change Request 11876. “However, each county will have only one wage index value. For counties that correspond to a different transition wage index value, the CBSA number will not be able to be used for FY 2021 claims.”

Solution: “In these cases, a number other than the CBSA number will be needed to identify the appropriate wage index value for claims for hospice care provided in FY 2021,” CMS explains. “These numbers are five digits in length and begin with ’50.’”

HHH Medicare Administrative Contractor CGS has listed the alternate CBSA codes at www.cgsmedicare.com/hhh/pubs/news/2020/09/cope18826.html.