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· Message from UHPCO President, Arla Webb

· Message from UHPCO Executive Director, Dan Hull, MPA

· Critical 2014 Days/Deadlines and Beyond

· CMS Issues Updates on Hospice HQRP Data Entry and HIS Training January 8, 2014 10:56 a.m.

· Hospice Open Door Forum: 1/22/14, 2-3PM ET

· MedPAC Gives Initial Approval to Freeze on FY2015 Hospice Payments Inclusion of Hospice under MA — Final Consideration at January Meeting

· Widespread Length of Stay Hospice Edits

· Part D Payment for Drugs for Beneficiaries Enrolled in Hospice: Request for Comments

· Modifications to the Revised Hospice Cost Report

· CMS Proposes New Emergency Preparedness Rule for all Medicare Providers

· Utah Auditor Information

· CR 8504 Medicare Benefit Policy Manual — RHC and FQHC Update — Chapter 13

· Hospice Certification and Recertification Attestation Requirements

· Webinar

Message from UHPCO President – Arla Webb

Good morning, everyone. We have two announcements that CMS and its hospice quality contractors have asked that we share with you –

1. The HQRP data entry and submission site is now available for registration and data submission (failure to submit this data – CY2013 data related to measure #0209 and the structural measure will result in a 2 percent reduction in FY2015 payment rates). New registration is required to submit the CY2013 data.

2. Registration for the ON SITE Hospice Item Set (HIS) Feb. 4 and 5 data collection training is now open; you must register by Jan. 27. Information is also provided about live streaming of the sessions; no registration is required for live streaming.

I’m providing the full text of the announcements below:

1. The Hospice Quality Reporting Program (HQRP) Data Entry and Submission Site link is now available for FY 2015 Reporting Cycle Data Submission.

The Hospice Quality Reporting Data Entry and Submission Site link is now available: https://hospice.qtso.com/. The site opened for user account registration, data entry and submission of 2013 measure data on January 1, 2014. This site will be utilized to enter and submit the 2013 Structural measure and the 2013 NQF #0209 Pain measure data to CMS for the FY 2015 payment determination. Data for each measure must be submitted to CMS by 11:59 PM Eastern Time on April 1, 2014 for payment determination.

PLEASE NOTE: User accounts that were established during the Jan. 1, 2013 - April 1, 2013 submission period are no longer valid. Each individual submitting measure data during the Jan. 1, 2014 through April 1, 2014 submission period must register for a new account.

The Technical User’s Guide for Hospice Quality Reporting Data Entry and Submission is also available as a download on the Data Submission portion of the CMS HQRP website. This is the primary reference for the HQRP Data Entry and Submission Site for the FY2015 Reporting Cycle.

2. Registration for the Hospice Item Set (HIS) Data Collection ON SITE Training is now available at https://www.eventbrite.com/e/hospice-item-set-his-data-collection-training-registration-10002003261

Registration will be open until 11:59 PM ET on Monday, Jan. 27, 2014. The training will be held at the CMS Central Office in Baltimore, MD, on Feb. 4and 5 from 12:30-4:30 pm each day. Participants will need to attend both afternoons; the 2/5 session is not a repeat of 2/4, but includes unique material. The number of participants on-site will be limited and the number of in-person participants per hospice will be limited to one. Early registration is recommended.

To ensure access to the training for ALL hospices, the training will be live-streamed, and will also be recorded and posted on the CMS website for on-demand viewing. Instructions for live video-streaming access will be provided at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-Item-Set-HIS.html. No registration is required for video-streaming. If you are unable to live-stream the HIS Data Collection Training, videos of the trainings will be posted on the same cms.gov site shortly after the training is complete.

This training will cover the data collection portion of the HIS only. Detailed training on the technical submission processes and data submission software will be provided in May. Additional information about that training and the associated registration will be announced at a later date.

The HIS Data Collection Training will closely follow along with the HIS Manual, which will be available on the CMS HQRP website in late January. A PDF version of the PowerPoint slide presentation will also be made available online prior to the training. In-person training participants are encouraged to print out a copy of the manual and the slide presentation before the training, as printed materials will not be provided at the training.

Theresa M. Forster

Vice President for Hospice Policy & Programs

National Association for Home Care & Hospice

Message from UHPCO Executive Director, Dan Hull, MPA

Dear Hospice Providers and members,

It was an exciting year in 2013 for our industry and this year will be a year of many adjustments. We anticipate a ruling from CMS about the Part D Drug program that would make most medications taken by Hospice patients coverable by the Hospice benefit and not by their Medicare Part D coverage. This is a change that will drive up our costs but not our reimbursement. I suggest that you try to evaluate this potential change within your patient census to see what the added cost would be. We don’t know yet about Diabetics and other chronic illnesses that aren’t part of the terminal illness but I am attaching the comments made by NHPCO so you can an idea of the problem.

I have been asked by Heidi Lafferty, our chair of the Education Committee to provide some of the changes or rule updates and deadlines for this year. Here is the list:

Deadlines for new rules:

October 1, 2014 ICD-10 and Oasis-C1

March 31st, 2014- deadline for new audit or edit of Part D Drugs and Hospices.

Hospice Item Set (Quality Reporting) implementation date July 1, 2014

New cost report requirements start date moved from Jan 1 2014 to Oct 1, 2014

Additional data on Hospice claims Voluntary reporting Jan1, 2014 mandatory- April 1, 2014

MedPac to recommend that Medicare advantage plans to require Hospice inclusion by 2017.

Emergency Preparedness Rule- Rule comments by February 25, 2014- rule to follow.

November 13 and 14, 2014-Hospice Convention in Sandy.

Have a great month and see you at our meeting on the 21st-Tuesday.

Dan Hull

Critical 2014 Days/Deadlines and Beyond:

· March 31, 2014 deadline for new audit or edit of Part D Drugs and Hospices.

· Hospice Item Set (Quality Reporting) implementation date July 1, 2014

· New cost report requirements start date moved from Jan 1 2014 to Oct 1, 2014

· Additional data on Hospice claims Voluntary reporting Jan1, 2014 mandatory- April 1, 2014

· Use of ICD-10 coding begins October 1, 2014

· MedPac to recommend that Medicare advantage plans to require Hospice inclusion by 2017. Currently Hospice can opt out if under a Medicare Advantage Plan and be paid straight Medicare.

CMS Issues Updates on Hospice HQRP Data Entry and HIS Training January 8, 2014 10:56 a.m.

The Centers for Medicare & Medicaid Services (CMS) and its hospice quality contractors have issues two announcements related to hospice quality data collection and reporting.

They are as follow:

1. The Hospice Quality Reporting Program (HQRP) data entry and submission site is now available for registration and data submission (failure to submit this data – CY2013 data related to measure #0209 and the structural measure -- will result in a 2 percent reduction in FY2015 payment rates). New registration is required to submit the data collected during CY2013.

The full text of the announcements is provided below:

The Hospice Quality Reporting Program (HQRP) Data Entry and Submission Site link is now available for FY 2015 Reporting Cycle Data Submission.

The Hospice Quality Reporting Data Entry and Submission site link is now available here.

The site opened for user account registration, data entry, and submission of 2013 measure data on January 1, 2014.

This site will be utilized to enter and submit the 2013 Structural measure and the 2013 NQF #0209 Pain measure data to CMS for the FY2015 payment determination. Data for each measure must be submitted to CMS by 11:59 PM Eastern Time on April 1, 2014 for payment determination.

PLEASE NOTE: User accounts that were established during the January 1, 2013 - April 1, 2013 submission period are no longer valid.

Each individual submitting measure data during the Jan. 1, 2014 through April 1, 2014 submission period must register for a new account.

The Technical User’s Guide for Hospice Quality Reporting Data Entry and Submission is also available as a download on theData Submission portionof the CMS HQRP website. This is the primary reference for the HQRP Data Entry and Submission Site for the FY2015 Reporting Cycle.

Registration for the Hospice Item Set (HIS) Data Collection ON SITE Training is now available here.

Registration will be open until 11:59 PM ET on Monday, January 27, 2014. The training will be held at the CMS Central Office in Baltimore, MD, on February 4 and 5 from 12:30-4:30 pm each day. Participants will need to attend both afternoons.

The session held on February 5 is not a repeat of the February 4 session, but includes unique material. The number of participants on-site will be limited and the number of in-person participants per hospice will be limited to one. Early registration is recommended.

No registration is required for video-streaming.If you are unable to live-stream the HIS Data Collection Training, videos of the trainings will be posted on the same cms.gov site shortly after the training is complete.

Hospice Open Door Forum: 1/22/14, 2-3PM ET

On Wednesday, January 22nd, from 2-3 PM ET, there will be an Open Door Forum focused on the Hospice Quality Reporting Program (HQRP). During this call, both the FY 2015 and FY 2016 Reporting Cycles will be discussed. In addition, the call will provide information about the upcoming patient/family survey requirements for hospices that will begin 1/1/2015.

The FY 2015 cycle consists of reporting on two measures: the structural measure and the National Quality Forum (NQF) #0209 pain measure. The Hospice Quality Reporting Program Data Entry and Submission Site is now available for data submission. Data for each measure must be submitted to CMS by 11:59pm ET on April 1, 2014 for FY 2015 payment determination. The Technical User’s Guide, posted on the Data Submission web page is the primary reference for the Hospice Quality Reporting Program Data Entry and Submission Site for the FY2015 reporting cycle.

As part of the FY 2016 Cycle, the Hospice Item Set (HIS) will be implemented on July 1, 2014. The HIS is a set of patient-level data items that can be used to calculate 6 NQF- endorsed measures and one modified NQF measure. Training on data collection for the HIS will be offered on February 4th and February 5th in Baltimore. Registration for the training is now open. Hospices may also live- stream the event if they are unable to attend in person, or watch the training online at a later date.

After a presentation of information about the FY 2015 and FY 2016 Reporting Cycles, there will be time for a Q&A session. Additional information about the ODF, including the agenda, call-in information and conference ID, will be posted to the Open Door Forum HHH and DME webpage: http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODF_HHHDME.html

Theresa M. Forster

Vice President for Hospice Policy & Programs

National Association for Home Care & Hospice

MedPAC Gives Initial Approval to Freeze on FY2015 Hospice Payments Inclusion of Hospice under MA — Final Consideration at January Meeting

At its December meeting, the Medicare Payment Advisory Commission (MedPAC) gave preliminary approval to inclusion of two recommendations directly related to hospice as part of its anticipated March 2014 report to Congress:

3. Inclusion of hospice as part of the benefits package under private Medicare Advantage (MA) plans (see NAHC Report, Nov. 19, 2013) ; and

4. A zero market basket update for fiscal year (FY) 2015 payments.

MedPAC chair Glenn Hackbarth noted that the Commission's zero update recommendation presumed no imposition of the 2 percent sequester; MedPAC hasn’t incorporated the sequester as a factor when it develops recommendations because it had been seen as a “temporary” measure on which Congress would likely take action. However, since it appears that the sequester may remain in place for the foreseeable future, MedPAC will likely include the impact of the sequester as a factor in developing its recommendations next year.

The Commission believes that hospice should be included under the MA benefit package to ensure that beneficiaries have seamless access to all Medicare benefits regardless of whether they are enrolled in traditional Medicare, a MA plan, or receive their care through an accountable care organization. If MA plans are required to offer hospice services, they will maintain responsibility for all costs of care at the end of life. Under the recommendation MA plans would receive an increase in their capitated payments to cover the cost of hospice care. Med PAC envisions a structure under which, in most cases, MA plans would contract with Medicare-certified hospices to provide care. At this time it appears that MedPAC would recommend that this change be effective in 2017, the year in which MA capitated payments will be equivalent to per capita payments under Medicare FFS, as the change at that time would have limited budgetary impact (an earlier transition would increase projected overall Medicare expenditures).