CMS is hosting a Special Open Door Forum (SODF) call on Tuesday, June 2, 2015 from 1:30 p.m. to 2:30 p.m. EST to provide home health agencies (HHAs) and other interested parties with additional information on the new “Pay-for-Reporting Performance Requirement” described in the CY 2015 Home Health Final Rule. The first 12-month reporting period for the new Quality Assessments (QAO) measure begins on July 1, 2015. HHA compliance will potentially affect the Annual Payment Update (APU) for CY 2017.
The session follows up on information presented during the Open Door Forum on November 12, 2014 and will include a review of the content and format of the new QAO Historical Performance Reports that will distributed to HHAs for information purposes only by the end of June.
Click here for a link to materials for this SODF, including a slide deck, a summary of the QAO methodology, and a sample QAO Historical Report.
A transcript and audio recording of this SODF will be posted here.
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In FY 2014, the Comprehensive Error Rate Testing (CERT) program found that more than half (51.4%) of home health claims were paid improperly. Approximately 90% of the 1308 CERT-reviewed claim lines in error were found to “have insufficient documentation errors.”
CMS is now considering developing a voluntary electronic clinical template and a voluntary home health paper clinical template to assist physicians and practitioners in documenting patient eligibility for the Medicare home health benefit. Using clinical templates may reduce the burden on physicians and practitioners who order home health services, according to CMS. The templates have been in the development process for the past year. As part of this process, CMS has been hosting a series of Special Open Door Forum calls to provide an opportunity for physicians/practitioners, home health agencies, and other interested parties to provide feedback on the draft templates. The final Open Door Forum to discuss these templates will be Tuesday, April 28, 2015 at 1:30p.m. EST.
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