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.

The two requirements are that you must adhere to the CAHPS Hospice Survey protocols, and you need to achieve at least 90% compliance with the 30-day transmission of your HIS data.

The HIS requirement involves completing the HIS at both the Start of Care and at the Discharge of your hospice patients. These records must then be transmitted to the QIES database within 30 days of their completion.

You can access the Timeliness Compliance Report in the QIES system, which allows you to print it anytime to track your compliance status within the 90% threshold throughout the year. An important point often overlooked is that HIS compliance is calculated based on the calendar year (January through December), while the payment reduction is applied according to the Hospice fiscal year (October 1 through September 30).

To provide a specific timeframe example, January through December of 2023 is assessed in early to mid-2024. Your report will be issued, and if you’re subject to the 4% reduction, you’ll be notified accordingly. The reduction in payments will commence from October 1, 2024, through September 30, 2025. Therefore, it’s crucial to review your Timeliness Compliance Report, accessible within the QIES system where you access your Casper report.

The second compliance requirement pertains to the CAHPS Hospice survey. To meet this requirement, you need to have a contract with a CMS-approved vendor to carry out the surveys. You provide them with access to the required patient information, and they conduct the surveys, gather the data, and submit it to CMS promptly. If you’re compliant with both the CAHPS Hospice survey and the timely filing of HIS data at 90%, you’ll qualify for the full annual payment update starting from October 1 of the following year.

If you require any assistance in assessing your compliance status under the Hospice Quality Reporting Program, please feel free to reach out to us.

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