HOSPICE: Hospice Provider Preview Reports Now Available, CMS List Serve, March26, 2020--Hospice provider preview reports and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey ® provider preview reports have been updated and are now available. These two separate reports are available in your Certification and Survey Provider Enhanced Reports (CASPER) non-validation reports folder. Hospice providers are encouraged to review their Hospice Item Set (HIS) quality measure results from Quarter 3, 2018 to Quarter 2, 2019 and their facility-level CAHPS® survey results from Quarter 3, 2017 to Quarter 2, 2019.
Providers have 30-days to review their HIS and CAHPS® results (March 12, 2020 through April 13, 2020) prior to the May 2020 Hospice Compare site refresh, during which this data will be publicly displayed.
HOSPICE: Important Updates on the Hospice Quality Reporting Program (HQRP), CMS List Serve, March 24, 2020
HOME HEALTH: Home Health Reason Code U5387 - Patient Still on Service, but the Final Claim's Dates of Service Don't Equal a 30-Day Period Timeframe, Palmetto GBA, March 26, 2020--Palmetto GBA has researched final claims that were Returned to the Provider(RTP) with reason code (RC) U5387 and found they incorrectly assigned that reason code. The RC states the patient was still on service due to a Patient Status code 30, but the "from" and "through" dates billed did not equal 30 days. The reviewed examples did have a complete 30-day period billed. However, during researching this issue, we did find the RAPs were either not approved/processed or were cancelling/cancelled when the final claims were received. Please check the status of the corresponding RAPs and correct them if necessary, then return the final claim for processing. This issue is in research and has been reported to the system maintainer. We will provide updates when applicable.
HOSPICE: Service Intensity Add-On (SIA) Payment Is Not Applying to Some Adjustments, Palmetto GBA List Serve, March 26, 2020--For some hospice adjustments, the end of life (EOL) Service Intensity Add-On (SIA) payment is not being added to the claims. This applies to some adjustments with dates of services prior to January 1, 2020, and later, that were received on or after January 1, 2020. This issue has been reported and a fix to resolve this issue is scheduled to be implemented on April 20, 2020. Home health agencies may adjust claims with SIA eligible services after the fix is implemented. We will provide updates when applicable. Please review this information and share it with your staff.
HOME HEALTH: Home Health Reason Codes U524P/U524Q - Some Home Health Final Claims are Cycling in the System for the Timing of the Period/Episode, Palmetto GBA, March 26, 2020--Some Home health final claims are cycling in the system for the timing of the period/episode. Reason codes U524P/U524Q state a home health final has a HIPPS code that is for an early period/episode and should be a late period/episode. The claims affected by this issue continue to cycle through status locations S B9000, S B9099 and S B0100 and continue to edit for reason codes U524P/U524Q. Please note that status locations S B9000, SB9099 and S B0100 are normal locations that claims go through while processing. Only claims that edit for reason codes U524P/U524Q in S B0100 continue to cycle through these locations. This issue has been reported to the system maintainer and a fix to resolve this issue is scheduled to be implemented on May 4, 2020. Cycling claims should process after the fix is implemented. We will provide updates when applicable.