Provider preview reports for the Hospice Item Set (HIS) are now available for hospices to view. The data involve the fourth quarter of 2015 through the third quarter of 2017.

SNF QRP Review and Correct reports now available

The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Review and Correct reports are now available on demand in the CMS Certification and Survey Provider Enhanced Reporting (CASPER) application. Providers can access these reports by selecting the CASPER Reporting link on the “Welcome to the CMS QIES Systems for Providers” webpage.

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Other Post-Acute News

New in the June issue of PPS Alert for Long-Term Care: New quality measure cracks down on eliminating medication issues identified during SNF stays

In the FY 2017 SNF PPS final rule, CMS adopted drug regimen review (DRR) as a new quality measure in the SNF Quality Reporting Program (QRP). Data collection will begin on October 1, 2018 for payment determinations being implemented in FY 2020. The DRR measure assesses whether providers are proactive in identifying and reconciling potential clinically significant medication issues. Specifically, this quality measure reports the percentage of resident stays in which a DRR was conducted at the start of care and whether timely follow-up with a physician occurred each time potential clinically significant medication issues were identified throughout a resident’s stay.

Ensuring an effective & efficient triple check process

The triple check process verifies claims for accuracy and compliance with Medicare regulations before billing. Since the Office of the Inspector General published a report that over a billion dollars of inappropriate payments were paid to skilled nursing facilities in 2009, many facilities have adopted the triple check process as a critical operational strategy to mitigate the risk of improper payments and triggering a Medicare audit.

Pressing “refresh” on your activities program

The Centers for Medicare & Medicaid Services’ latest revised Conditions of Participation place a stronger emphasis on person-centered care and resident preferences, a realm where activities serve as a core concept. However, current residents are more discerning than ever before and have different interests than they used to. Planning and designing new activities that fit diverse resident needs, all while keeping residents active and engaged, is a major challenge for long-term care professionals.

SNF therapy contracts: Your risks and what you need to know

The use of contracted therapists in your SNF immediately increases your citation and criminal risk in terms of billing and liability. These facilities must understand how to limit such risk under Medicare due to improper treatment and coding of your therapy contractor, including how to implement a shared risk arrangement with your therapy contractor while outlining a strategic way to monitor such risk within your SNF.

Put Your QAPI Plan Into Action, Prepare for CoPs, Achieve 5-Star Rating

CMS has granted home health agencies six additional months to prepare the Conditions of Participation—so don’t waste any more time. Implementing the CoPs is a huge time and cost burden so the sooner agencies begin to put policies and procedures into place, the better off they’ll be on Jan. 13, 2018.

Product Spotlight

Skilled Nursing Facility Billing Boot Camp

Skilled Nursing Facility Billing Boot Camp provides hands-on, how-to education focusing on billing for Medicare Part A and B, the ins and outs of consolidated billing, accurately completing the UB-04. Plus, guidance on understanding the SNF coverage criteria and a breakdown of the different beneficiary notices.

Upcoming CMS Events

Thursday, June 15, 1:30pm – 3:00pm ET - National Partnership to Improve Dementia Care and QAPI Call

Tuesday, June 20, 1:00pm - 2:00pm ET - IMPACT Act Special Door Forum

Thursday, June 29, 1:00 – 3:00 ET - Improvements to the Medicare Claims Appeal Process and Statistical Sampling Call

Wednesday, July 5 - Home Health, Hospice, and Durable Medical Equipment Open Door Forum