public reporting will continue to be the most recent 8 quarters of data, excluding the exempted quarters; Quarter 1 and Quarter 2 of CY 2020. However, section 1814(i)(5)(D)(ii) of the Act provides that in the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical measure has not been endorsed by the consensus-based entity, the Secretary may specify measures that are not endorsed, as long as due consideration is given to measures that have been endorsed or adopted by a consensus-based organization identified by the Secretary. NHPCO has prepared the FY 2022 MEDICAID Hospice State/County Rate charts with the rates for every county in every state in the country for all levels of care, for use by NHPCO members. The commenter claimed that the proposed methodology only captures salaries and benefits of physicians, nurse practitioners, RNs and hospice aides. This means CMS requires that hospices submit 90 percent of all required HIS records within 30-days of the event (that is, patient's admission or discharge). The hospice must notify the Division of the name of the physician/nurse practitioner who has been designated as the attending physician/nurse practitioner by the member. Washington, D.C. 20201 The HCI will complement the existing HIS Comprehensive Measure and does not replace any existing reported measures. 599 0 obj <> endobj The 'Wage Index' links contain the listing of Core Based Statistical Area (CBSA) codes and the corresponding wage index. 3. Numerator: Total skilled nursing minutes provided by a hospice on all RHC service days within a reporting period. We appreciate the support for HOPE and reiterate our commitment to providing updates and engaging stakeholders through sub-regulatory means. We proposed that hospice star ratings for each measure be assigned based on where the hospice-level measure score falls within these cut-points. The Meaningful Measure Initiative areas are intended to increase measure alignment across programs and other public and private initiatives. Submission requirements are codified in 418.312. Comments specific to HCI noted that abnormalities due to the COVID-19 PHE would affect all of the indicators, while those for HVLDL indicated that the number of in-person visits likely fell during the COVID-19 PHE due to patient and caregiver preferences, with implications for quality measurement. Methodology for Calculating Compensation Costs, a. 5. To derive the compensation cost weights for each level of care, we first proposed to begin with a sample of providers who met new Level I edit conditions that required freestanding hospices to fill out certain parts of their cost reports effective for freestanding hospice cost reports with a reporting period that ended on or after December 31, 2017. As discussed in this section, the HVLDL and HCI claims-based measures support the Meaningful Measures initiative and address gaps in HQRP. Section 3(a) of the IMPACT Act mandated that all Medicare certified hospices be surveyed every 3 years beginning April 6, 2015 and ending September 30, 2025. Background and Description of the CAHPS Hospice Survey, b. Overview of the CAHPS Hospice Survey Measures, d. Public Reporting of CAHPS Hospice Survey Results, e. Volume-Based Exemption for CAHPS Hospice Survey Data Collection and Reporting Requirements, f. Newness Exemption for CAHPS Hospice Survey Data Collection and Public Reporting Requirements, h. Proposal to Add CAHPS Hospice Survey Star Ratings to Public Reporting, 9. but we will consider addressing this policy in future rulemaking. Another exclusion was made prior to reporting the numbers in Table B.1. The final rule (CMS-1754-F) can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/current. This could include a special open door forum or other venues for interaction. One commenter indicated that comprehensive competency testing can take up to a full 8-hour day and a targeted approach will save time related to this requirement. Standard Public Reporting (SPR) Scenario: We used data from the four quarters of CY 2019, which represent CY 2020 public reporting in the absence of the temporary exemption from the submission of PAC quality data, as the basis for comparing simulated alternatives. They encouraged HHS to continue pursuing adoption of FHIR APIs for health IT vendors. For more information, please visit the PAC PUF web page at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/PAC2017. The Hospice Item Set V3.00 PRA Submission replaced the HVWDII measure with a more robust version: The claims-based measure HVLDL. Paragraph (b)(1) will include the existing language on the standardized set of admission and discharge items. Denominator: Total skilled nursing minutes provided by the hospice during RHC service days within a reporting period. However, in the preamble of the FY 2022 Hospice proposed rule (86 FR 19700) and in this final rule is a description for each indicator including the rationale, numerator, denominator, exclusion criterion, and data sources. Hospice Care For each hospice, we sum together all skilled nursing minutes provided on RHC days that occur on a Saturday or Sunday and divide by the sum of all skilled nursing minutes provided on all RHC days. However, the prohibition does not pertain to the provision of an item or service for the purpose of alleviating pain or discomfort, even if such use may increase the risk of death, so long as the item or service is not furnished for the specific purpose of causing or accelerating death. for better understanding how a document is structured but It illustrates how the CY interacts with the FY payments, covering the CY 2020 through CY 2023 data collection periods and the corresponding APU application from FY 2022 through FY 2025. Unlike inpatient prospective payment system (IPPS) hospitals, inpatient rehabilitation facilities (IRFs), and skilled nursing facilities . Response: We appreciate MedPAC raising this concern. 19(6):681-687. doi:10.1634/theoncologist.2013-0457. Thus, we proceeded with including these data in measure calculations for the November 2020 refresh. This means that their scores will not be displayed on Care Compare, and consumers will not have information about them to inform their decisions about selecting a hospice. This will allow us to report the maximum amount of new data, maintain reliability of the data, and permit the maximum number of hospices to receive scores. We appreciate the concern that consumers may not know about the component measure scores in the Provider Data Catalogue. Nursing services require initial and ongoing assessment of patient family needs to ensure the successful preparation, implementation, and refinements for the plan of care. on .https://www.cms.gov/files/document/guidance-memo-exceptions-and-extensions-quality-reporting-and-value-based-purchasing-programs.pdf. Final Rule Action: We are finalizing as proposed at 418.76(c)(1) our policy that hospices may conduct competency testing by observing an aide's Start Printed Page 42552performance of the task with a patient or pseudo-patient. Final Decision: In summary, in response to public comments, we are adopting the revised hospice labor shares calculated as we proposed with a slight modification to the methodology to derive the overhead benefit calculations as described previously. 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hospice rates 2022 by county and cbsa