Eli's Hospice Insider

Published on Wed Aug 17, 2016 PDF

Timely reporting threshold jumps to 80% Jan. 1.

If you don’t know what your Hospice Item Set submission rate is, you’d better check before it costs you.

Last year, the Centers for Medicare & Medicaid Services finalized a policy requiring hospices to submit HIS records within 30 days of the event date, which is the patient’s admission date or discharge date. The threshold for satisfying the requirement was that 70 percent of HIS records be submitted in that timeframe.

Now CMS is continuing with its plan to increase that threshold to 80 percent in calendar year 2017 and then 90 percent in 2018. If hospices don’t make the benchmark, Medicare will dock their pay 2 percent in 2019 and 2020, respectively, CMS notes in the 2017 hospice payment final rule in the Aug. 5 Federal Register.

When a CMS contractor ran analysis of HIS submission data from 2014, it found that 88 percent of hospices would have met the 80 percent compliance threshold at that time, CMS notes. “This analysis is further evidence that the compliance thresholds are reasonable and achievable by hospice providers,” CMS says in the rule.

Tip: On July 17, “CMS released the Hospice Timeliness Compliance Threshold Report, which is a CASPER report that allows providers to check their preliminary compliance with the 70/80/90 compliance threshold,” CMS says in a fact sheet available via its HIS website. “Specifically, this report will display provider identification information, # of HIS records submitted, # of HIS records submitted on time and % of HIS records submitted on time.” The link to the fact sheet, which contains more information about accessing the new timeliness report, is in the “Downloads” box at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-Item-Set-HIS.html.