Federal Register - August 4, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations
TABLE 11: HQRP Reporting Requirements and Corresponding Annual Payment Updates Reporting Year for HIS and Data Reference Year for CARPS
.
Exemption CARPS
Collection Year for CARPS data Calendar ear CY2020
019
CY2021
CY2022
CY2023
Beginning in FY 2024 and all subsequent years, the payment penalty is 4 percent. Prior to FY 2024, the payment penalty is 2 percent.
As illustrated in Table 11, CY 2020
data submissions compliance impacts the FY 2022 APU. CY 2021 data submissions compliance impacts the FY
2023 APU. CY 2022 data submissions compliance impacts FY 2024 APU. This CY data submission impacting FY APU
pattern follows for subsequent years.
c. Submission Data and Requirements As finalized in the FY 2016 Hospice Wage Index and Payment Rate Update final rule 80 FR 47192, hospices compliance with HIS requirements beginning with the FY 2020 APU
determination that is, based on HIS-
Admission and Discharge records submitted in CY 2018 are based on a timeliness threshold of 90 percent. This means CMS requires that hospices submit 90 percent of all required HIS
records within 30-days of the event that is, patients admission or discharge.
The 90-percent threshold is hereafter referred to as the timeliness compliance threshold. Ninety percent of all required HIS records must be submitted and accepted within the 30-day submission deadline to avoid the statutorilymandated payment penalty.
To comply with CMS quality reporting requirements for CAHPS,
hospices are required to collect data monthly using the CAHPS Hospice Survey. Hospices comply by utilizing a CMS-approved third-party vendor.
Approved Hospice CAHPS vendors must successfully submit data on the hospices behalf to the CAHPS Hospice Survey Data Center. A list of the approved vendors can be found on the CAHPS Hospice Survey website:
www.hospicecahpssurvey.org. Table 12.
HQRP Compliance Checklist illustrates the APU and timeliness threshold requirements.
TABLE 12: HQRP Compliance Checklist
FY 2023
FY 2024
CAHPS
Submit at least 90 percent of all HIS records within 30 days of the event date patients admission or discharge for patient admissions/discharges occurring 1/1/20 12/31/20.
Submit at least 90 percent of all HIS records within 30 days of the event date patients discharge admission or for patient admissions/discharges occurring 1/1/21 12/31/21.
Submit at least 90 percent of all HIS records within 30 days of the event date patients discharge admission or for patient admissions/discharges occurring 1/1/22 12/31/22.
Ongoing monthly participation in the Hospice CARPS survey 1/1/2020 12/31/2020
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Most hospices that fail to meet HQRP
requirements do so because they miss the 90 percent threshold. We offer many training and education opportunities through our website, which are available 24/7, 365 days per year, to enable hospice staff to learn at the pace and time of their choice. We want
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hospices to be successful with meeting the HQRP requirements. We encourage hospices to use this website at: https
www.cms.gov/Medicare/QualityInitiatives-Patient-AssessmentInstruments/Hospice-Quality-Reporting/
Hospice-Quality-Reporting-TrainingTraining-and-Education-Library.
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Ongoing monthly participation in the Hospice CARPS survey 1/1/2021 12/31/2021
Ongoing monthly participation in the Hospice CARPS survey 1/1/2022 12/31/2022
For more information about HQRP
Requirements, please visit the frequently-updated HQRP website and especially the Best Practice, Education and Training Library, and Help Desk web pages at: https www.cms.gov/
Medicare/Quality-Initiatives-PatientAssessment-Instruments/Hospice-
E:FRFM04AUR4.SGM
04AUR4
ER04AU21.150
FY 2022
HIS
ER04AU21.149
Annual Payment Update