Healthcare Provider Solutions

The Hospice Quality Reporting Program (HQRP) webpage released an Important Update on 12/31/20 regarding the implementation of the Hospice Item Set (HIS) version V3.00 specifications. The Update stated that on January 1, 2021, CMS will move forward with the implementation of V3.00 of the HIS data submission specifications. The HIS Manual V3.00 is not yet final and is still pending approval from the Office of Management and Budget (OMB). The implementation of the HIS V3.00 specifications will prevent hospice providers from encountering any fatal errors/rejected records whether submitting HIS records with or without section O. Either V2.00 or V3.00 HIS records will be accepted by the ASAP system and for hospice providers to continue to monitor the HQRP website for additional updates. .

 

What you need to know…

 

1. The new version of the HIS V3.00 does not include Section “O” which is the section that gathers visit data. CMS will use hospice claims data to obtain visit data and will Replace the Hospice Visits When Death is Imminent measure with the Hospice Visits in Lasts Days of Life measure which will capture RN and MSW visits in at least two of the last three days of life for hospice patients.

2. All HQRP measures in the past included data for all hospice patients regardless of payor however, because claims-based data available to CMS is only for Medicare hospice patients, Patient Visit Data in the last days of life for non-Medicare hospice patients will not be used in the HQRP after January 1, 2021. All HQRP measures that are not claims based will continue to be used for all hospice patients regardless of the payor.

3. The revised HIS-Discharge instrument is not yet available and CMS indicated during the CMS Open Door Forum call on December 16, 2020 that they expect the form to be approved and available very soon. There will not be a negative impact on hospice providers who continue to utilize HIS V2.00 with admissions and discharges on January 1, 2021. CMS included on the call that hospices who continue to use the current version of the HIS-Discharge instead of the updated HIS V3.00 will not have their data submissions rejected and all the data, except the data Section “O” will be transmitted to CMS.

 

Hospice Quality Reporting Program (HQRP) Reporting Reminders

 

Data submission for Calendar Year (CY) 2021 for the Hospice Quality Reporting Program (HQRP) begins January 1, 2021 and runs though December 31, 2021. Hospices must meet the quality reporting requirements for this period for both the Hospice CAHPS Survey and the Hospice Item Set (HIS) for admission and discharge to avoid a 2-percentage point payment reduction in the Annual Payment Update (APU) for FY2023.

 

HIS Submission Requirements:

 

− The HIS data for Admission and Discharge must be submitted for all patients within 30 days of the event or target date.
− The act of submission does not equal acceptance.
− It is recommended that hospices submit data within 7–14 days to be sure of acceptance by the 30 – day deadline.
− After submitting the HIS data be sure to review the final validation report for errors.
− Beginning in FY2020 and forward hospice providers must submit 90% of all required HIS records by the 30-day deadline to avoid a 2-percentage point reduction in their APU.

HIS Records Submission Threshold Payment Year
CY 2021 90% FY 2023

CAHPS Hospice Survey

 

During CY 2021, the CAHPS Hospice Survey will continue data collection as normal. This means that deadlines for data submission to the CAHPS Hospice Survey data warehouse will occur on the second Wednesday of the month in February, May, August, and November.

 

CAHPS Hospice Survey Upcoming Data Submission Deadlines in CY 2021

 

Quarter Dates of Deaths Data Submission Deadline
Q3 2020 July-September 2020 February 10, 2021
Q4 2020 October-December 2020 May 12, 2021
Q1 2021 January-March 2021 August 11, 2021
Q2 2021 April-June 2021 November 10, 2021

 

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