Reviewing HHVBP Updates in the Recently Released Interim and Annual Performance Reports

The July release of the Interim Performance Reports (IPR) were released at the end of July, and the reports include the first quarter of 2025 OASIS Outcome Measures, along with the remaining measures through December 31, 2024.

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Understanding the New Medicare Spending Per Beneficiary Measure in the 2026 Home Health Proposed Rule

One of the most significant additions is a new measure called the “Medicare Spending Per Beneficiary Post-Acute Care Measure”. To help explain this change, Jennifer Osburn, one of our consultants here at Healthcare Provider Solutions, will walk us through the key components of how the Medicare Spending Per Beneficiary calculation is determined.

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Guidance for HOPE Tool Access for Transmissions

Today, we’ll be addressing updates to the Hospice Quality Reporting Program. A newly released 5-part video series is now available to support training on the HOPE tool. The first of the five-part series offers an introduction and general overview of HOPE.

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2026 Hospice Final Rule Released

The 2026 Hospice Final Payment and Regulatory Update Rule was published on August 1 and aligns closely with what was outlined in the proposed version, confirming anticipated provisions and updates.

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Takeaways from the 2026 Home Health Proposed Rule & Guidance for Submitting Effective Comments

The newly released 2026 proposed rule for home health brings significant implications for our industry—below are key takeaways and guidance to help you craft impactful comments during the open comment period.

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Understanding Updates to the Hospice Quality Reporting Program

Today, we’ll be addressing updates to the Hospice Quality Reporting Program. A newly released 5-part video series is now available to support training on the HOPE tool. The first of the five-part series offers an introduction and general overview of HOPE.

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2026 Home Health Proposed Rule Released

On June 30, 2025, CMS released the 2026 Home Health Proposed Rule, and with this proposal comes the introduction of a number of unexpected and significant changes that could have far-reaching impacts across the industry.

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Explaining the Upcoming ICD-10 Coding Update that will Take Effect October 1

Updates to ICD-10 occur twice each year—once in April and again in October. An upcoming ICD-10 coding update will take effect on October 1. While the April releases may bring some changes, and occasionally none at all, the October update is typically more significant.

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Hospice Trends to Watch: What CMS Monitoring Data Reveals

A recent report on Hospice Monitoring by CMS presented statistics that provide a clear view of current trends and may highlight key areas for evaluation within your organization. The data is compelling and serves as a valuable resource for understanding how hospice agencies are performing across various metrics.

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Understanding the Latest Clarifications on Home Health Face-to-Face Requirements

Face-to-Face Encounters are once again a central topic of discussion in Home Health. The regulation has been in place since 2011, with an update issued in 2015. Since April 1, 2015, the regulation itself has remained unchanged. However, over the past decade, including in 2025, there have been numerous clarifications.

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Understanding a Notice of Medicare Non-Coverage Update that Agencies Overlooked

An important topic needs to be addressed that seems to have been overlooked by some agencies related to the recent update to the Notice of Medicare Non-Coverage, which took effect on January 1, 2025. We previously shared a Monday Minute discussing the new requirement that Medicare Advantage patients must now receive the same Notice of Medicare Non-Coverage form as traditional Medicare patients. This includes the BFCC-QIO information.

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Preparing for HOPE: Key Updates to Guidance Manual Ahead of the October 1 Implementation

In the last week of April, a new version of the Guidance Manual for completing the HOPE tool was released, along with an updated version of the HOPE itself. That manual includes several updates, a few of which I’ll be sharing with you today.

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Addressing Outpatient Code Editor Error that is causing Home Health Billing Rejection Frustrations

A home health billing rejection issue is leading to significant frustration and needs to be addressed. On April 25th, 2025, CMS issued Change Request 13992 to update the Outpatient Code Editor.

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2026 Final Rule for Medicare Advantage Programs Released

The newly issued Final Rule for the Medicare Advantage programs will take effect in 2026. Medicare Advantage programs are set to receive a 2.83% increase in the rates paid to them by the federal government, helping to support the healthcare needs of their beneficiaries.

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How Home Health and Hospice Agencies can Submit Input to Influence Healthcare Deregulation

An important opportunity is now available for healthcare providers to help reduce outdated and burdensome regulations across the industry. The Hospice Proposed Rule was issued a couple of weeks ago, along with a request for information focused on deregulation across the healthcare industry.

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2026 Hospice Proposed Rule Released

On April 11, 2025, the Hospice Proposed Rule for 2026 was finally released. It is scheduled to be published in the Federal Register on April 30th.

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Understanding the Future of Medicare Cost Reporting for Home Health and Hospice Agencies

In the coming months, an important topic that will become a priority for many home health and hospice agencies is the submission of your annual Medicare Cost Report. The OIG recently released a report after auditing Cost Reports to evaluate whether Medicare MACs were effectively overseeing Medicare Cost Report filings. Their findings were less than favorable.

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Telehealth for Face-to-Face Encounters has been Extended until September

We’re excited to share that the use of telehealth for face-to-face encounters has been extended until September 30, 2025. The extension permits both home health and hospice to continue conducting face-to-face encounters on behalf of home health.

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Reviewing Updated Information on the CAHPS Hospice Survey

In a previous Monday Minute, we reviewed significant changes to the CAHPS Hospice Survey. In that Minute, we mentioned that we would be sharing additional details as we got closer to the implementation phase. Today, we are providing the latest updates on the survey.

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Four New OASIS Items for 2027 – Health-Related Social Needs

Today, we’re going to explore the possibility of four new items possibly being incorporated into your current comprehensive assessment—well before they are set to officially become part of the OASIS document in 2027. This would allow us to start identifying the key areas to highlight once they take effect.

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Understanding the Difference between Conditions of Participation and Conditions of Payment

The difference between the Conditions and Participation and the Conditions of Payment is a crucial topic, and a critical issue regarding the distinction between the two needs to be addressed. When discussing the Conditions of Participation, it’s well understood that compliance with CoPs is essential. Whether in home health or hospice, surveyors carefully review these conditions during their surveys.

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Reviewing Significant Changes to the CAHPS Hospice Survey Set to Take Effect on April 1

Major updates to the CAHPS Hospice survey, which were outlined in the Hospice Final Rule released August 2024, will take effect April 1, 2025. Related documents for the CAHPS survey changes are dated online January 2025. It’s essential to confirm that your CAHPS vendor is ready to implement the new processes and forms by April 1.

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Clarifying Uncertainty Surrounding the Timely Initiation of Care Outcome Measure

A long-established outcome measure for home health, the Timely Initiation of Care Outcome Measure, seems to have some uncertainty surrounding it that we’d like to clear up. The Timely Initiation of Care Outcome Measure is determined using the dates recorded in the OASIS document.

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Understanding the Increased Focus on Teaching Episodes and What Medical Reviewers are Looking for in the Documentation

Recently, audits like Targeted Probe and Educate (TPE), UPIC, SMRC, and RAC have become more frequent, especially since the start of the year. A notable area of focus for home health agencies that wasn’t heavily scrutinized in the past is teaching episodes.

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Self-Reporting your Hospice Aggregate Cap: Reviewing the Details

We have approached the time of the year to address the self-reporting of your Hospice aggregate CAP. For this year, the aggregate CAP must be submitted by February 28, 2025, and will cover the fiscal year ending on September 30, 2024.

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Reviewing Recent Home Health Value-Based Purchasing Updates

The October Interim Performance Reports (IPR) were delayed and were eventually published in December 2024. If you have not yet reviewed the most recent IPR reports, they are now available in your iQIES system.

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Understanding Important Updates Regarding Credit Balance Reports and Telehealth Face-to-Face Encounters

Two important updates from the end of 2024 need to be communicated to both home health and hospice teams regarding Credit Balance Reports and Telehealth Face-to-Face Encounters.

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2024 Home Health Year in Review and Looking Forward to 2025

As we close out 2024, Home Health has been a rocky road at best. We expect that this will continue into 2025, but with advocacy efforts comes the potential for improvement.

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2024 Hospice Year in Review and Looking Forward to 2025

As we close out 2024, Hospice has had a roller coaster ride for sure during this year and that will continue into 2025.

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Reviewing Changes Outlined in the OASIS-E1 Final Guidance Manual

The updates include the addition of one new item to the OASIS. Additionally, two items will be removed entirely, a change anticipated due to their limited relevance in OASIS calculations. Three existing items have been revised refer to the manual for further details on those updates. Lastly, the skip pattern for M0102 has been updated.

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New Regulation Requiring Notice of Medicare Non-Coverage to Include BFCC-QIO Information

A new regulation has been released regarding Medicare Advantage plans. If you are providing home health services to a patient enrolled in a Medicare Advantage plan, you are now required to issue the Notice of Medicare Non-Coverage. This notice must include information about the BFCC-QIO, allowing patients the opportunity to appeal decisions related to their discharge.

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Understanding the Most Recent Home Health Value Based Purchasing Model (HHVBP) Reports

The October 2024 Interim Performance Reports provide data for the previous 12 months, ending in June 2024 for OASIS data and March 2024 for HHCAHPS and claims data. It is crucial to regularly monitor your reports and address any significant discrepancies between your expected scores and those shown in the interim reports.

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CMS Releases 2025 Home Health Final Rule & Quality Update

The much-anticipated 2025 Home Health Final Rule was posted Friday, November 1, 2024, and includes applicable changes for implementation in calendar year (CY) 2025 and beyond.

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Reviewing Updates to the Home Health Quality Reporting Program

In October 2024, the data on the Care Compare site was refreshed. With this update, the Acute Care Hospitalization and Emergency Department measures were removed.

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Understanding the Impact Medicare Open Enrollment has on Your Agency

Medicare Open Enrollment runs from October 15 to December 7, granting patients the opportunity to switch from traditional Medicare to a Medicare Advantage plan or move from one Medicare Advantage plan to another. This time of year can be challenging, not only for your agency, which may be impacted by patients’ decisions, but also for patients and their families as they navigate the process and determine the best choices for themselves or their loved ones.

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Selections for Hospice Special Focus Program to Take Place in November

The Hospice Special Focus Program, which was finalized about a year ago, will select the list of participating hospices taking place in the program in November of 2024. During the selection process, from the group identified as the bottom 10% of performers—those with the highest scores, which indicate poorer performance—a list will be published on the Special Focus Program website.

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CMS Waivers and Donation Efforts in the Wake of Hurricanes Helene and Milton

As the Southeast grapples with the aftermath of recent hurricanes, communities are coming together to support one another during these challenging times. The devastation wrought by these storms has been profound, and with that comes information regarding waivers that CMS has issued.

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Expanded Pre-Payment Announced in Four States

In a recent update regarding Hospice services, it was announced that the extension of prepayment reviews will occur in four states. This initiative is part of what’s being referred to as Expanded Targeted Probe and Educate.

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Reviewing Rare Updates to the 2025 Home Health Consolidated Billing Listing

Since its introduction approximately 20 years ago, changes to the Home Health Consolidated Billing listing have been rare. In the most recent release of the 2025 listing, 71 new codes have been added to the listing.

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Understanding Updates to the Home Health Quality Reporting Program

Many updates have been released in relation to the Home Health Quality Reporting Program. The first of which pertains to the HHCAHPS Star Ratings Preview Reports that were released in September, and will influence the Care Compare update coming in October 2024.

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Reviewing Important HOPE Tool Information in the 2025 Hospice Final Rule

The Hospice Outcomes and Patient Evaluation Tool, or HOPE Tool, is a clinical assessment tool that will completely replace the HIS, and will be mandatory for all patients, regardless of their payer or age. The HOPE Tool has been in development for quite some time and, although it was finalized in the 2025 rule, it won’t officially take effect until October 1, 2025.

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CMS Provides Clarifications on the Conclusion of the Hospice VBID Demonstration

Earlier this month, CMS released new information regarding the development that the hospice VBID demonstration would be terminated, effective December 31, 2024. With the VBID demonstration ending, there were many questions regarding the impact on patients, specifically concerning payers and benefits.

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CMS Releases Preview Annual Performance Reports for the Home Health Value-Based Purchasing Model

CMS has recently released the Preview Annual Performance Reports for the Home Health Value-Based Purchasing Model. You can access these reports in the iQIES system, where you’ve been reviewing the Interim Performance Reports (IPR). This Preview Report introduces, for the first time, the percentage calculations showing how your 2023 results will affect your 2025 payments.

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Reviewing Wage Index and CBSA Classification Changes in the 2025 Home Health Proposed Rule

In addition to the Hospice Proposed Rule having many updates related to the Wage Index and CBSA classifications, the Home Health Proposed Rule also outlined several updates. Though both contained updates, there are occasional differences in the wage index results between home health and hospice.

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Understanding the Impact OASIS Section GG Changes will have on Home Health Agencies

The GG section of the OASIS is about to have a huge impact on all home health agencies through the Home Health Value-Based Purchasing Model. The GG items on the OASIS document have been included for several years and were originally taken from the SNF Assessment.

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Interim Performance Reports (IPR) July 2024 Update Released

Last week, the July update to the Interim Performance Reports (IPR) was released, marking the first time, data from all of 2023 has been included in the reports. The data covers all 12 months for every measure in Value-Based Purchasing.

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Mastering Managed Care: Strategies for Success in the Evolving Home Care Landscape

Reimbursement stands out as a primary concern among home care providers. Over time, we’ve witnessed a shift in the landscape, moving from 90%-100% reliance on traditional Medicare to a mix where only 40%-50% comes from traditional Medicare. For those not yet engaging with managed care, this shift has likely impacted their census.

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2025 Home Health Proposed Rule Clarifies Mandatory OASIS Requirements

On June 26, CMS released the 2025 Home Health Proposed Rule. Among the changes in this proposed rule include updates to OASIS requirements that will become mandatory in 2025.

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PECOS Requirement Update Outlined in FAQ Document Released by CMS

The Centers for Medicare & Medicaid Services (CMS) released a Frequently Asked Questions (FAQ) document regarding the PECOS enrollment requirement for certifying Hospice physicians, effective June 3. This document clarified important details that must be understood about your claims processing.

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BFCC-QIO Changes that could Impact Medical Review

The BFCC-QIO, an organization that patients and caregivers can turn to for filing complaints or expressing concerns about the care or information they’ve received from a provider, is set to undergo changes.

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New Draft Legislation Released Could Affect Hospice Payment and Integrity Programs

On June 13, a congressman from Oregon released a comprehensive draft addressing changes in hospice payment and integrity programs. This proposed legislation has the potential to significantly affect hospices nationwide.

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Understanding the Two Hospice Quality Reporting Program Requirements Hospices Must Comply with to Avoid Payment Reductions

In order to avoid a 4% reduction in your upcoming annual payment update, it is essential that hospices are compliant with the Hospice Quality Reporting Program. These Hospice Quality Reporting Program requirements have been established for a while, yet every summer, many hospices across the nation are unexpectedly finding themselves non-compliant with specific aspects of these requirements.

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April Home Health Value Based Purchasing IPR Reports Released

At the end of April, the latest release of the Home Health Value Based Purchasing Interim Performance Reports (IPR) was released. This edition includes data calculations for the OASIS items through December 2023, providing a full year’s worth of data for 2023.

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Review Choice Demonstration Extended for Five More Years

The Review Choice Demonstration, a program that offers home health agencies several options for claim reviews, has been extended for another five years. This demonstration, managed by the Medicare Administrative Contractor Palmetto GBA, is currently in effect in five states.

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New Change Request Could Cause Payment Delays for Home Health and Hospice Agencies

CMS has issued a Change Request, number 13449, titled “Stay of Enrollment”, and it is crucial that home health and hospices agencies, as well as other suppliers such as Physicians and Durable Medical Equipment (DME) providers all understand this request.

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Important Updates and Clarifications for Home Health Claim Processing

At the beginning of April, CMS issued key updates and clarifications regarding home health claim processing. The changes were issued through Change Request 13543. This Change Request transmittal brought a number of clarifications to the claims processing manual.

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Deadline Extended for Physician Enrollment in PECOS System

CMS announced on Friday, April 26, that the deadline for PECOS enrollment for attending and certifying physicians in hospice has been extended. Initially, the 2024 Hospice Final Rule stipulated that by May 1, 2024, all attending and certifying physicians, including MDs, DOs, and DPMs, needed to be registered in PECOS or be opted out.

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Understanding the Proposed Adjustments to CAHPS Hospice Surveys

CAHPS Hospice Surveys have been a longstanding component of the hospice program. These surveys have presented challenges for hospices, not only in terms of their content but also in securing the responses needed to make an impact on outcome measures. In the 2025 Hospice Proposed Rule, many proposed adjustments to CAHPS Hospice Surveys are on the table.

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Important Updates to Interpretive Guidelines for Home Health Surveys

In the March update, several changes have been made to the Interpretive Guidelines for Home Health Surveys. From clarifications to comprehensive assessments to nuanced adjustments in infection prevention protocols, each change adds layers of complexity for agencies striving for excellence in home health care delivery.

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Take Action Today: Two Ways to Support your Home Health Agency’s Future

Healthcare Provider Solutions is requesting your participation in two important endeavors that are tailored to support your home health agency now and in the future. The first request is the Medicare Advantage Survey and the second is to attend NACH Spring Advocacy Day.

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Strategies for Navigating the Surge of Home Health Medical Reviews

Home Health Medical Review is experiencing another surge, although not as significant as the escalation observed in hospice. Nevertheless, it’s proving to be a challenge for several home health agencies.

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VBID Model Hospice Carve-In to End in December 2024

The Value-Based Insurance Design (VBID) model has included a hospice carve-in since 2021. Shockingly, it has been announced within the VBID demonstration framework that the hospice carve-in will conclude on December 31, 2024.

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Understanding the Top Two Reasons for Hospice Medical Review Denials

In today’s Monday Minute, Melinda discusses two of the most crucial causes for denial in hospice medical review and outlines proactive measures to avoid them. An increase in denials is occurring due to two very important hospice medical review topics – the Face-to-Face Encounter and the Certificate of Terminal Illness.

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January 2024 IPR Reports Released

The January 2024 IPR Reports have been published, updating the home health Value-Based Purchasing Model scores for agencies, using 2023 data. The reports, which were published in the first week of February, also provide updates to the July and October reports.

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Recent Edit is Blocking Home Health and Hospice Claims from Being Paid

A recent edit is blocking home health and hospice claims from being paid at Palmetto GBA, and possibly at NGS and CGS as well. The edit, which begins with the number “5” and the letter “Z”, is not only stopping payment but is also changing the bill type to a 320 for home health.

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3 Ways to Avoid Hospice Election Statement Denials

Numerous hospice agencies are dealing with denials due to a prevalent medical review issue, specifically related to the Hospice Election Statement.
The Election Statement was updated in October 2020, emphasizing the inclusion of three specific components.

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Clarifying Common Misconceptions of Patient Driven Groupings Model (PDGM) HIPPS Code Calculations

Common misconceptions regarding the calculation of the Patient Driven Groupings Model (PDGM) HIPPS codes exist and need clarification.

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Hospice Clarifications for Marriage & Family Therapists and Mental Health Counselors

In the Hospice Final Rule last year, a change was made to the Conditions of Participation for hospices that states they could now have family therapists and mental health counselors as part of their Interdisciplinary Group (IDG). However, understand that it is not required for hospices to hire marriage and family therapists, or mental health counselors.

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Recent Updates to the Home Health Value-Based Purchasing Expansion

As a result of updates to the Home Health Value-Based Purchasing Expansion, CMS has introduced a new email address, released a comprehensive resource document, and released a document providing a summary of a conversation had by the Technical Expert Panel.

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Release of New OASIS-E1 Draft Details Several Upcoming Changes

A draft of the new OASIS-E1 has been released. This revised version is set to take effect on January 1, 2025.

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2024 Medicare Eligibility Verification Strategies for Home Health and Hospice

As we enter the new year, it is crucial to conduct a new Eligibility Verification Run for every patient on your census in both Home Health and Hospice. This will ensure that the correct payer is billed for patient care.

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Preparing for the Hospice Special Focus Program Selection Process

As a response to the Consolidated Appropriations Act of 2021, the Hospice Special Focus Program was created to identify hospices who have poor quality outcomes based on quality indicators. A technical expert panel collaborated with CMS to establish the most effective approach for conducting the Special Focus Program and its content.

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The War Against the Behavioral Adjustment and How You Can Help

Since the release of the Home Health Proposed Rule in July of 2023 for 2024, the significance of the Behavioral Adjustment has been strongly emphasized – it’s a war we are losing and need to take action on.

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Hospice Preview Reports Available for Review and Reporting

In mid-November, Hospice Preview Reports were released containing information about your Hospice. The information in these reports will be made available as part of the February 2024 refresh of the Care Compare website. Between November 15 and December 15, you’ll have the opportunity to thoroughly review the Preview Reports and report any discrepancies or issues you find in your data.

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Home Health Value-Based Purchasing Model Changes Effective 2025

The Home Health Final Rule for 2024 that was published at the beginning of November contained many changes – including ones that will specifically impact the Home Health Value-Based Purchasing Model in 2025.

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2024 Value-Based Insurance Design (VBID) Model Update

Under the VBID model, hospices are subject to the activity involved in the demonstration when a patient is enrolled in one of the participating benefit plan packages. In September 2023, the VBID demonstration participation list was updated, as it is every September, for the period of January through December of 2024.

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2024 Home Health Final Rule Released

The Home Health Final Rule for 2024 was published on November 1, 2023, and with it comes many changes. The outlined changes in the 531-page document will go into effect starting on January 1, 2024.

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October IPR Reports Released for HHVBP

In today’s Monday Minute, Melinda discusses the insight that can be taken from the October 2023 IPR reports.

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Payment Reduction when the Home Health Quality Reporting Requirements are Not Met

In this Monday Minute, we discuss the mandatory compliance of the Home Health Quality Reporting program.

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Open Enrollment of Medicare Advantage plans and the Impact it Could Have on Your Agency

In this Monday Minute, we discuss Open Enrollment for the Medicare benefit and the impact it could have on Home Health and Hospice agencies.

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Preview Reports Released for the January 2024 Home Health Quality Reporting Program Care Compare Refresh

In this week’s Monday Minute, we discuss the recent release of preview reports for the Home Health Quality Reporting Program, which will be used for the Care Compare data refresh in January 2024.

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OIG Report Focuses on the Lack of Accurate OASIS Documentation of Falls with Major Injury

In this Monday Minute, we discuss the latest OIG report which focuses on the accurate OASIS documentation of fall related injuries.

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Hospice Physicians Required to be in PECOS System 2024

In this week’s Monday Minute, we discuss the requirement of physicians to be registered in the PECOS system.

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Recent Changes for Medicare Home Health Billing

In this Monday Minute, we discuss some recent changes concerning the billing of home health claims.

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Reviewing Proposed Changes to the Home Health Value-Based Purchasing Model for 2025

In this week’s Monday Minute, we discuss the proposed changes specific to the Home Health Value-Based Purchasing model that will go into effect in 2025.

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Addressing Recent Updates to the Hospice Quality Reporting Program

In this week’s Monday Minute, we address the latest release to the Hospice Provider Preview Reports of the Hospice Quality Reporting Program. Additionally, we will be discussing the significant 4% payment reduction that will be imposed if the HQRP requirements are not met.

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Reviewing the July 2023 Home Health PEPPER Report

In today’s Monday Minute, we discuss the Home Health PEPPER report released July 2023.

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Reviewing the 2024 Hospice Final Rule

In this week’s Monday Minute, we discuss the 2024 Hospice Final Rule that was released July 2023.

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Reviewing the First IPRs in the Recent Value-Based Purchasing Model Update

In today’s Monday Minute, we discuss the nationwide expansion of Value-Based Purchasing in 2023 and the release of the first IPR reports for review.

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Reviewing New Oversight Measures in Hospice Care

In this week’s Monday Minute, we are focusing on the latest changes to Hospice integrity in fours states and SRMC medical review project.

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Reviewing the 2024 Home Health Proposed Rule

In this weeks Monday Minute, we discuss the 2024 Home Health Proposed Rule.

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Understanding the Implications for Hospice in the OIG’s 2023 Work Plan

In this Monday Minute, we discuss an update to the OIG work plan surrounding General Inpatient Care (GIP).

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Your Voice Matters: Advocacy Needed for the Home Health Industry

In this week’s Monday Minute, we highlight a crucial home health advocacy effort that requires your active participation.

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Reviewing the July IPR Release for the 2023 Home Health Value-Based Purchasing Expansion (VIDEO)

In this week’s Monday Minute, we discuss the IPR (Interim Performance Reports) that will be released in July for the Home Health Value-Based Purchasing Expansion for 2023.

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Hospice May 2023 Refresh to Care Compare (VIDEO)

In today’s Monday Minute, we discuss the most recent update to Care Compare with the Hospice Quality Reporting Program outcomes.

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Updated ABN Form Mandatory Implementation June 30, 2023 (VIDEO)

In today’s Monday Minute, we discuss the updated Advanced Beneficiary Notice (ABN) Form.

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Understanding the Impact of PIPR Reports on Medicare Certified Home Health Agencies (VIDEO)

In this week’s Monday Minute, we discuss the latest updates to the Value-Based Purchasing model, specifically focusing on the April 2023 release of the Pre-Implementation Performance Reports (PIPR).

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Clarifying Occupational Therapy’s Role in Start-of-Care Assessments and Home Health Admission (VIDEO)

In this Monday Minute, we discuss the clarification surrounding Occupational Therapists being allowed to conduct a Start-of-Care comprehensive assessment.

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Telehealth Clarification at the End of the Public Health Emergency for Home Health and Hospice (VIDEO)

In this Monday Minute, we discuss the official end of the Public Health Emergency on May 11, 2023, causing many of the 1135 waivers to be discontinued on the same day.

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Reviewing the Implications of the Recent VBID Model Update (VIDEO)

In this week’s Monday Minute, we discuss the recent update to the Value-Based Insurance Design (VBID) model, which includes the Hospice benefit.

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First Look at Updated Hospice PEPPER Reports and Proposed Rule 2024 (VIDEO)

In this week’s Monday Minute, we discuss the recent updates in the Hospice PEPPER Reports and take a look at the Proposed Rule 2024.

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Discussing CMS Call regarding the Behavioral Adjustment Being Applied to Home Health Rates (VIDEO)

In this week’s Monday Minute, we discuss the challenges faced by the Home Health industry regarding the calculation of behavioral adjustment rates.

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Waivers Ending for Hospice Agencies as the Public Health Emergency is Terminated (VIDEO)

In this Monday Minute, we will talk about the waivers ending for hospice agencies as the Public Health Emergency ends.

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Waivers Ending for Home Health Agencies as the Public Health Emergency is Terminated (VIDEO)

In this week’s Monday Minute, we will talk about the waivers ending for home health agencies as the Public Health Emergency ends.

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Importance of Home Care Staff Education on HHCAHPS Scores (VIDEO)

In this week’s Monday Minute, we discuss HHCAHPS survey language and the significance of its use in communicating with patients to ensure positive outcomes.

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Clarifying New Telehealth G-Codes for Home Health Claims (VIDEO)

In this Monday Minute, we clarify the new G-Codes for telehealth encounters.

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High-Level Advocacy Efforts Needed for Home Health and Hospice Providers (VIDEO)

In this Monday Minute, we discuss the need for high-level advocacy efforts and how you can participate in the March on Washington to fight back against negative regulatory decisions in our industry.

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Hospice Self-Reported Aggregate Cap Due by February 28 (VIDEO)

This week’s Monday Minute, we discuss time-sensitive information regarding the Hospice Aggregate Cap.

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Value-Based Purchasing Pre-Implementation Performance Reports (PIPR) January 2023 Release (VIDEO)

In this week’s Monday Minute, we review the January 2023 provider Pre-Implementation Performance Reports (PIPR) that have been issued by CMS for Value-Based Purchasing.

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Public Health Emergency Planned to End on May 11, 2023 (VIDEO)

In this Monday Minute, we discuss the end of the Public Health Emergency and its impact on telehealth and more.

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Discussing the January 2023 Quarterly OASIS-E Q&A (VIDEO)

In this week’s Monday Minute, we discuss questions that were asked in the quarterly OASIS-E Q&A released on January 17, 2023.

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Sudden Reactivation of Code 31755 and the Impact it Has on Claims (VIDEO)

In this Monday Minute, we discuss CMS reactivating billing reason code 31755 edit without warning and how that affects claims.

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Reviewing April 1, 2023 ICD-10 Coding Updates (VIDEO)

In this Monday Minute, we discuss updates to ICD-10 codes that will go into effect April 1, 2023.

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January 2023 Care Compare HHCAHPS Star Rating Update & HHCAHPS Reminders for Value-Based Purchasing (VIDEO)

In this week’s Monday Minute, we discuss the HHCAHPS Star Rating update that is coming soon to the Care Compare site and HHCAHPS reminders for Value-Based Purchasing.

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The Impact of 2022 Omnibus Legislation on Home Health and Hospice (VIDEO)

In this Monday Minute, we discuss the content of the recently passed Omnibus budget legislation as it relates specifically to Home Health and Hospice.

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Impact of December 2022 CAHPS Hospice Survey Update (VIDEO)

In this week’s Monday Minute, we talk about the December 2022 CAHPS Hospice Survey update.

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Advocacy Needed in Home Health and Hospice to Prevent Rate Cuts (VIDEO)

In this Monday Minute, we discuss the needed advocacy for Home Health and Hospice to prevent rate cuts.

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CMS Updates to the OASIS-E Guidance Manual (VIDEO)

In this week’s Monday Minute, we discuss the update to the OASIS-E Guidance Manual that was released by CMS in December 2022.

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Updated G-Codes Relating to Telehealth and Billing Non-Routine Supplies in Home Health (VIDEO)

This Monday Minute discusses Telehealth G-codes effective January 1, 2023 and billing Non-Routine Supplies.

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Coding Changes for Home Health Related to the PDGM Model (VIDEO)

In this Monday Minute, we will discuss specific coding changes related to the PDGM model for Home Health.

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Reviewing Home Health Value-Based Purchasing Pre-Implementation (VIDEO)

In this week’s Monday Minute, we will review the Home Health Final Rule regarding Value-Based Purchasing that is set to begin in January 2023.

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Medicare Open Enrollment and its Impact on Home Health and Hospice (VIDEO)

This Monday Minute discusses the Medicare Open Enrollment period and how that impacts both Home Health and Hospice agencies.

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Reviewing the 2023 Home Health Final Rule (VIDEO)

In this Monday Minute, we review the 2023 Home Health Final Rule that was released on October 31, 2022.

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HHCAHPS Survey Impact on the Value-Based Purchasing Model (VIDEO)

This week’s Monday Minute discusses the HHCAHPS survey’s impact on the Value-Based Purchasing model that will begin on January 1, 2023.

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2023 Update on the VBID Model’s Hospice Component (VIDEO)

In this Monday Minute, we discuss the recent 2023 information related to the Hospice component of the Value-Based Insurance Design (VBID) Model.

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Department of Health and Human Services Extends Public Health Emergency to January 11, 2023 (VIDEO)

In this week’s Monday Minute, we discuss the announcement made by the Department of Health and Human Services that the Public Health Emergency has been extended for an additional 90 days.

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Implementation of OASIS-E and High Level Changes to the Data Set (VIDEO)

This Monday Minute reviews highlights of the instruction for completion of some of the new items in OASIS-E and other changes to the Data Set.

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Hospice New Rates 2023, ICD-10 Codes Updated & PDGM Proposed (VIDEO)

In this Monday Minute, we discuss the many changes that have gone into effect beginning on October 1, 2022 for Hospice and Home Health.

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Medical Review and Plan for the Next Visit Documentation (VIDEO)

This Monday Minute discusses the requirements of documenting the true plan for the next visit on individual visit notes and what consequences will be paid under Medical Review when not accurately documented.

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How QAPI Processes Can Support Improvement in Home Health Value-Based Purchasing (VIDEO)

In this Minute, we will discuss the updated fact sheet related to the Public Health Emergency for the status of waivers for both home health and hospice individually.

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Telehealth Used for Face-to-Face to Extend Beyond Termination of the Public Health Emergency (VIDEO)

In this Minute, we will discuss the updated fact sheet related to the Public Health Emergency for the status of waivers for both home health and hospice individually.

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Clarifying Requirements for Coding and the Face-to-Face Encounter (VIDEO)

In this Monday Minute, we will discuss a question that frequently comes up when discussing coding and the Face-to-Face encounter, especially under Medical Review.

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Two Important Updates for Outcome Measures and Data Reporting for Hospice (VIDEO)

This Minute will highlight two important outcome measures and data reporting that will be incorporated into the Care Compare site for Hospice.

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Advocacy Needed to Preserve Access to Home Health (VIDEO)

This Minute is to spark needed advocacy on behalf of home health agencies nationwide to stop the reduction of home health rates that were proposed by CMS.

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Review Choice Demonstration Cycle Selection Update (VIDEO)

This Minute reviews the current cycles and upcoming selection dates in some states.

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2023 Hospice Final Payment Rule (VIDEO)

This session will review the key highlights from the 2023 Hospice Final Rule. Payment rates have increased, the Hospice Cap is set and the HOPE is looking for Beta testers. Don’t miss it!

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OASIS-E Highlighted Changes (VIDEO)

This Minute will review, at a very high level, some significant changes involved with OASIS-E implementation.

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2022 Home Health PEPPER Update (VIDEO)

This Minute will review highlights of the July 2022 release of the updated PEPPER.

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CAHPS Hospice Survey Impact (VIDEO)

This Minute will discuss thoughts surrounding the impact that field staff have on the results of the CAHPS Hospice Survey.

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2023 Home Health Proposed Payment Rule (VIDEO)

This Minute will do a high-level review of the reimbursement and Value-Based Purchasing proposed changes for 2023.

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Clarification on Hospice Transfers (VIDEO)

This Minute will review the clarification that CMS is providing regarding the fact that Hospice transfers cannot have a break in days in billing.

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Transmittal Regarding NPP Oversite has been Rescinded (VIDEO)

This Minute will review the requirement that CMS tried to implement regarding collaboration with physicians when a NPP is certifying and/or signing home health orders and the result of the challenge, in the original transmittal being rescinded.

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OASIS-E Implementation is Imminent! (VIDEO)

This Minute will provide a high-level overview of the release of the OASIS E Guidance Manual and the significance of starting education NOW!

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Detail Review of Hospice PEPPER Content (VIDEO)

This Minute will review some of the detail content of the Hospice PEPPER, specifically the newly added PEPPER targets.

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Hospice Targeted Probe & Educate Update (VIDEO)

This Minute will review some of the current activity with hospice scrutiny in Targeted Probe & Educate. We have seen a huge influx of medical review focused specifically on hospice, which includes Targeted Probe and Educate, since September 2021.

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Value Based Purchasing Benchmarks & Achievement Thresholds (VIDEO)

This minute reviews details surrounding the release of the baseline year benchmarks and achievement thresholds.

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Home Health Claims & NOA Errors that Continue to Plague Agencies (VIDEO)

This Monday Minute reviews current claims processing issues and highlights of the penalty exception requests process.

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Sequestration is BACK! (VIDEO)

This Monday Minute will review the sequestration deduction that is once again being applied to all Medicare payments.

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Brief Announcement Regarding Medicare Advantage (VIDEO)

This Monday Minute will briefly review the recent CMS rule regarding cost-sharing and the phases of VBID preparation for 2023.

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Diagnosis Coding Update for April 1, 2022 (VIDEO)

This Monday Minute will briefly review the new ICD-10 Diagnoses related to COVID Vaccinations.

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Value Based Purchasing – Impact of OASIS Items (VIDEO)

This Monday Minute will take you through some of the key components of OASIS and the impact they have on the Value Based Purchasing outcome measures.

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2023 Hospice Proposed Rule Recap (VIDEO)

This Monday Minute will begin unfolding the important content of the Hospice Proposed Rule for 2023.

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HHCAHPS Impact on Value Based Purchasing & the Exemption Deadline (VIDEO)

This Monday Minute will highlight the deadline for HHCAHPS Participation Exemption and review the impact that the HHCAHPS results will have on Value Based Purchasing as it is rolled out in January 2023.

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Home Health Value Based Purchasing – Rollout 2023 (VIDEO)

This Monday Minute will touch on the highlights of the nationwide implementation of Home Health Value Based Purchasing, effective 1/1/2023.

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Hospice Certificate of Terminal Illness (VIDEO)

This Monday Minute reviews the requirement of the certifying physician to create a clinical narrative, specific to the patient, as a part of hospice certification.

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OASIS-E – Coming January 2023 (VIDEO)

This Monday Minute will provide a reminder about the swift approaching implementation of OASIS-E.

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OIG Report Released Regarding NonHospice Payments While Patients are on Hospice Services (VIDEO)

This Monday Minute will review the OIG Report and what it possibly means for the future of Hospice Medical Review Audits & Investigations.

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Help Stop Sequestration through Advocacy Lead by the National Association for Home Care & Hospice (VIDEO)

This Monday Minute provides encouragement for agencies to assist in advocacy regarding the sequestration deduction that is soon to be reinstated.

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Update on the Notice of Admission NOA 2022 (VIDEO)

This Monday Minute will review the confirmed requirement that all home care agencies will have to request exception on ALL late NOAs, even if it was a MAC claims processing system error.

We will provide the links to the Medicare MAC websites, specifically to the claims processing logs.

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Care Compare January 2022 Refresh for HHQRP

This Monday Minute will take you through the highlights of the January 2022 Care Compare refresh of data.

We will provide a link to the updated Tips Report which gives you all of the information discussed in this minute plus more.

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Telehealth During the Continuing Public Health Emergency (VIDEO)

This Monday Minute navigates the details of what can and can not be done regarding Telehealth during the current Public Health Emergency.

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Public Health Emergency Extension (VIDEO)

This Monday Minute will highlight the issues related to the Public Health Emergency as it impacts home health and hospice waivers.

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Compliance with the Hospice Quality Reporting Program (HQRP) (VIDEO)

This Monday Minute reviews the two components of the HQRP that impact the hospice reimbursement, if noncompliant.

There are two portions to the Hospice Quality Reporting Program. One is related to the CAHPS Hospice Survey participation, and the other is related to the HIS transmission requirement and today we will look into both.

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The NOA Kicks 2022 off with a Bang! (VIDEO)

This Monday Minute reviews the current situation with the Notice of Admission and some key thoughts about moving forward.

The Medicare Home Health Notice of Admission has been what some would call a nightmare. All three of the Medicare MACs have had some level of issue with correct processing.

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VBID Awareness as Hospice enters 2022 (VIDEO)

This Monday Minute will touch some very key points for Hospices in regard to the VBID demonstration.

The VBID demonstration started, of course in 2021, and will continue in 2022 into phase two. With 2022 beginning there are going to be several Medicare Advantage Plans added to the VBID model.

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NOA, Hospice Medical Review & Sequestration is Back! (VIDEO)

This Monday Minute will review the TOP concerns moving into 2022, including the sequestration deductions beginning again. We want to share with you a couple of things on the three most important transitional things as we move into 2022 for both Home Health and Hospice.

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Notice of Admission 2022: EMR Failures (VIDEO)

This Monday Minute will review the critical aspects of the Notice of Admission that includes the cross-over periods from 2021 and the necessity of access to the Direct Data Entry (DDE) system.

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Home Health & Hospice Quality Reporting Programs (VIDEO)

This Monday Minute will review the reality that the Home Health and Hospice Quality Reporting Program requirements were reinstated with penalties as of July 1, 2020. We will review the deadlines, what is included in those, and the penalties that will be assessed if you are not compliant.

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NEW GG Item Education for OASIS Completion (VIDEO)

This Monday Minute assists in making agencies aware of the new GG Item Education that CMS has published on their website for OASIS completion. We have provided a link to this new education and hopefully, you’ll find it very useful in the training of your staff specific to the GG Items in the OASIS documentation.

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2022 Home Health Final Rule Includes DELAY in VBP (VIDEO)

This Monday Minute will review the 2022 Home Health Final Rule highlights, including the exciting announcement that Value Based Purchasing will be delayed until 2023. With this nationwide rollout being put off until January 2023, CMS is allowing for agencies to receive additional education to be able to figure out exactly how this Value Based Purchasing process works and be able to more fully understand how your agency can be successful under the Value Based Purchasing Model.

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Value-Based Insurance Design (VBID) Model: Hospice and Medicare Advantage in 2022 (VIDEO)

This Monday Minute will take you through a brief update on the 2022 VBID model, which includes Hospice in the Medicare Advantage Organization plans that have volunteered to participate in the VBID demonstration.

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The Extension of the Public Health Emergency (PHE) (VIDEO)

This Monday Minute will review the extension of the Federal Public Health Emergency, share some concerns that may impact agencies at the state level and some very important things to note regarding this extension of the PHE. It was set to expire in October of 2021 but now has been extended to the third week of January of 2022.

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Local Coverage Determinations (LCD) (VIDEO)

This Monday Minute reminds home health and hospice about the significance that the LCD can have in the medical review of Medicare charts. We want to remind you about a very important document that the Medicare MACs have developed to help assist agencies in understanding the expectation of your medical record documentation.

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The Impact of Hurricane Ida

This Monday Minute will touch on the impact that Hurricane Ida has had on home health and hospice and exceptions granted by CMS to this area.

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Medicare Claims Processing Issues Logs (VIDEO)

This Monday Minute emphasizes the importance of reconciling payments to your AR and the significance of the Medicare MAC claims processing issues logs.

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Hospice and Home Health PEPPER Reports (VIDEO)

This Monday Minute discusses the impact that PEPPER Reports can have on a Home Care or Hospice agency. We also share the information needed to access your agency’s PEPPER Reports and when these reports are released annually.

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Medicare Eligibility Verifications (VIDEO)

This Monday Minute will touch on the significance of Medicare Eligibility Verifications and a key update to the content of Workers’ Comp and Liability Policies in the Common Working File. We will point out something that we have discovered, that could be a significant help in situations where you do that Eligibility Verification, so watch to learn more about Medicare Eligibility Verifications to have a successful enrollment.

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Phase 4 Provider Relief Funds and 60-day Grace Period (VIDEO)

This Monday Minute reviews the content of the HHS announcement regarding the, now available, $25.5 billion in additional provider relief funds. 8 billion of this money is to be given to small providers primarily in rural areas and bonuses will be given to providers that serve primarily Medicaid, CHIP and/or Medicare patients.

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Implementation of the Notice of Admission (VIDEO)

This Monday Minute will take you through the key elements of the coming Notice of Admission and provide references. We want to share with you a document that was published by Palmetto GBA, CGS and NGS, all three of the Home Health Medicare MAC’s this past week. This document goes through the details of what is going to be included in the Notice of Admission, beginning January 1st of 2022.

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Case-Mix Weight Changes in the HH Proposed Rule 2022 (VIDEO)

This Monday Minute provides thoughts about the potential impact of the proposed case-mix weight changes on overall reimbursement in 2022.

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Value Based Purchasing Nationwide Rollout 2022 (VIDEO)

This Minute briefly reviews some of the highlights of Value Based Purchasing and what has been proposed. Value-Based purchasing has been proposed in the form of a nationwide rollout for home health beginning in January 2022.

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Targeted Probe & Educate: Here We Go Again! (VIDEO)

This Minute will take you through a quick recap of the Targeted Probe & Educate framework as the program is being reinstated!

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Proposed CoP Changes that Need Your Feedback (VIDEO)

This Minute reviews the four items that are being proposed for change in the Home Health Conditions of Participation, specific to home health aide supervision. Make sure to stay tuned for more updates!

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2022 Hospice Final Rule Released (VIDEO)

This minute covers a quick recap of The Hospice Final Rule released on July 29, 2021 that updates Medicare hospice payments and the aggregate cap amount for FY 2022 in accordance with existing statutory and regulatory requirements. Make sure to stay tuned for more updates!

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Review Choice Demonstration Update (VIDEO)

This minute covers the update for Florida and North Carolina Home Health Review Choice Demonstration (RCD). Palmetto GBA provides HHAs with a wealth of information addressing the requirements and expectations of the RCD. Make sure to stay tuned!

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Hospice Survey Changes in the Home Health Proposed Rule (VIDEO)

This minute is to make you aware that there are tons of pages in the 2022 Proposed Home Health Rule that are specific to Hospice. HPS will also have upcoming material that will discuss these updates. Make sure to stay tuned!

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More Details on the 2022 Home Health Proposed Rule (VIDEO)

This minute covers more details on the 2022 Home Health Proposed Rule. Register for our June15th webinar for more in depth information. Make sure to stay tuned!

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The Home Health Proposed Rule 2022 (VIDEO)

This minute covers some of the changes for the Home Health Proposed Rule that were released on June 21st. Make sure to stay tuned!

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OSHA Emergency Temporary Standard (VIDEO)

This minute covers the COVID-19 Healthcare ETS (Emergency Temporary Standard) being officially filed in the Office of the Federal Register on June 17, 2021, and it became effective when it was published on June 21, 2021. Make sure to stay tuned!

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Provider Relief Funds Reporting Update (VIDEO)

This minute covers the HHS revision of the Post-Payment Notice of Reporting Requirements as of June 11, 2021. This new version supersedes all previous versions of the Post-Payment Notice of Reporting Requirements documents. Make sure to stay tuned!

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Increase in COVID-19 Vaccine Administration Payments (VIDEO)

This minute covers the news release from CMS concerning: Medicare Billing for COVID-19 Vaccine Shot Administration. Effective June 8 of 2021, CMS has now approved that the COVID vaccination administration payment is going to be $75 per shot, which is almost double what they had increased it to earlier this year. The emphasis on getting as many people vaccinated as we possibly can is apparent. Make sure to stay tuned!

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Post Payment Reviews Inside the Public Health Emergency (VIDEO)

This minute covers the news release from CMS concerning, MACs Resume Medical Review on a Post-payment Basis. Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. Make sure to stay tuned!

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Home Health Value-Based Purchasing Annual Report (VIDEO)

This Minute covers a review of the Home Health Value-Based Purchasing (HHVBP) Model – Fourth Annual Report. Make sure to stay tuned!

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Emergency Preparedness Update (VIDEO)

Today’s video clip covers the Updated Guidance for Emergency Preparedness memo released in March of 2021. You need to thoroughly review all of the changes that have taken place in this update. Make sure to stay tuned!

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Notice of Admission Transmittal (VIDEO)

This Minute covers the highlights of Transmittal 10758, dated May 11, 2021 with updates to the Medicare Claims Processing Manual regarding the NOA implementation for January 2022. Make sure to stay tuned!

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Hospice Proposed Rule Comments & Happy Nurse’s Month! (VIDEO)

Welcome to Monday Minute with Melinda! This Minute highlights some very key components of the Hospice Proposed Rule that needs your feedback. Make sure to stay tuned!

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The HEAT Act (VIDEO)

Welcome to Monday Minute with Melinda! This Minute is a call to action regarding the Senate bill the HEAT Act. Please review and participate. Make sure to stay tuned!

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COVID Vaccine Administration Billing Update & Extension of the Public Health Emergency (VIDEO)

Welcome to Monday Minute with Melinda! This session reviews the details of the Condition Code that must be used in billing vaccine administration for Medicare Advantage enrolled patients. Additionally, we touch on the extension of the PHE and corresponding CMS Waivers. Make sure to stay tuned!

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Sequestration, Reminder Regarding NPPs in Home Health & Update on Claims Processing (VIDEO)

Welcome to Monday Minute with Melinda! Welcome to Monday Minute with Melinda! This session is loaded with updates regarding sequestration, claims processing and the use of NPPs in Home Health. Make sure to stay tuned!

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2022 Hospice Proposed Rule (VIDEO)

Welcome to Monday Minute with Melinda! This video clip gives you some highlights of the just issued proposed rule and resources for obtaining details. Make sure to stay tuned!

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Medicare Regulatory Update (VIDEO)

Welcome to Monday Minute with Melinda! This video clip will provides an update on Sequestration claims hold, Advanced & Accelerated Payments & Provider Relief Funds! Make sure to stay tuned!

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Accelerated and Advance Payment Recoupment to Begin (VIDEO)

Welcome to Monday Minute with Melinda! This video clip will recap the process of Medicare recouping the Accelerated and Advance Payments from 2020. Make sure to stay tuned!

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COVID-19 Vaccine Administration (VIDEO)

Welcome to Monday Minute with Melinda! This week’s video clip will discuss the billing and reimbursement for COVID-19 Vaccine Administration. Make sure to stay tuned!

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OIG Conducting Audit on Telehealth (VIDEO)

Welcome to Monday Minute with Melinda! This video clip will recap some of the documentation requirements for telehealth and the OIG audit to take place. Make sure to stay tuned!

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Hospice ADRs on the Rise! (VIDEO)

Welcome to Monday Minute with Melinda! This week’s video clip will provide some key elements of responding to Hospice ADRs. Monday Minute with Melinda gives agencies the opportunity to receive critical weekly video updates, Make sure to stay tuned!

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Exceptions for Late RAPs! (VIDEO)

Welcome to Monday Minute with Melinda! This week’s video offers quick tips on ensuring that you are coding appropriately for requesting an exception to a late RAP in 2021. Monday Minute with Melinda gives agencies the opportunity to receive critical weekly video updates, Make sure to stay tuned!

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Home Health Final Claim Clarification (VIDEO)

Monday Minute with Melinda gives agencies the opportunity to receive critical weekly video updates. This week, Melinda highlights the most recent clarification for Medicare Home Health Billing of Final Claims in 2021. Help with cleaning out your Return to Provider Claims is just a click away!

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