Federal Register


DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 418 Medicare Program; FY 2020 Hospice Wage Index and Payment Rate  Update and Hospice Quality Reporting Requirements This proposed rule would update the hospice wage index, payment rates, and cap amount for fiscal year 2020. This rule proposes to rebase the continuous home care, general inpatient care, and the inpatient respite care per diem payment rates in a budget-neutral manner to more accurately align Medicare payments with the costs of providing care. In addition, this rule proposes to modify the election statement by requiring an addendum that includes information aimed at increasing coverage transparency for patient under a hospice election. Finally, this rule proposes changes to the Hospice Quality Reporting Program.  To review, go to: https://www.govinfo.gov/content/pkg/FR-2019-04-25/html/2019-08143.htm.


Federal News and Information

 Identifying Prior Hospice Days When Calculating Hospice Routine Home Care Payments After a Transfer

Change Request (CR) Number 10180 calls for changes to Medicare’s claims processing systems to correct the number of days used to determine the 60 days of high Routine Home Care (RHC) payments on hospice claims. It ensures that the count includes the days provided by another hospice when there is a transfer during a benefit period. Previously, Medicare instructed you to account for this by reporting the benefit period start date as the admission date on your claim in the case of transfers. While this workaround resulted in correct payments, it required you to submit misleading information. The requirements in CR 10180 instruct the Common Working File (CWF) to identify prior days correctly in transfer situations, so that you no longer need to use this workaround as of the implementation date of July 2, 2018.


For more information, go to:  https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10180.pdf.


The official instruction, CR 10180, issued to your MAC regarding this change, is available at https://www.cms.gov/Regulations-andGuidance/Guidance/Transmittals/2018Downloads/R2014OTN.pdf.


Minimum Business Requirements to Administer the CAHPS Hospice Survey

To administer the CAHPS Hospice Survey, organizations must meet all of the CAHPS Hospice Survey Minimum Business Requirements. In addition, subcontractors and any other organizations performing major CAHPS Hospice Survey administration functions (e.g., mail/telephone operations) must also meet all of the CAHPS Hospice Survey Minimum Business Requirements that pertain to that role. Organizations requesting consideration for approval to administer the CAHPS Hospice Survey must meet all of the posted CAHPS Hospice Survey Minimum Business Requirements at the time the CAHPS Hospice Survey Participation Form is received (a subcontractor’s or other organization’s survey administration experience does not substitute for a survey vendor’s).


The CAHPS Hospice Survey Participation Form should become available in the next month. Survey vendors that are currently approved to administer the CAHPS Hospice Survey are not required to submit a CAHPS Hospice Survey Participation Form (unless the survey vendor is requesting to be approved for additional modes of survey administration or the survey vendor does not have any contracted hospice clients and it has been two years since the survey vendor received approval to administer the CAHPS Hospice Survey).

For more information, CAHPS deadlines (Information for Hospice) and to ensure you are aware of CAHPS bulletins, go to:  https://hospicecahpssurvey.org/en/whats-new/.


Texas News and Information

Department of State Health Services (DSHS) 

2019 Long Term Care Nurse Staffing Study

The Texas Center for Nursing Workforce Studies at the Department of State Health Services is asking all Administrators of home health and hospice agencies in Texas to complete a short survey in spring 2019.

Purpose: To assess the size and effects of the nursing shortage in home health and hospice in Texas. Data collected from this survey will help guide stakeholders and legislators in developing policy recommendations and establishing legislative priorities. TCNWS is the only organization that collects this important information.

When:  The survey will be available April 1st – May 31st.

How:  You may complete the survey online at http://www.dshs.texas.gov/chs/cnws/2019-HHHCNSS starting on April 1st.

At the end of March, Administrators of Texas home health and hospice agencies will be mailed materials to aid in the completion of the survey. You can find these materials, as well as more information on the study, at: http://www.dshs.texas.gov/chs/cnws/2019-HHHCNSS.

Please be aware that your survey responses will be strictly confidential. All findings will be reported in aggregate form only. Individual hospitals will not be identified.

Should you have any questions regarding this survey, please contact:

Cate Campbell, MPH

Texas Center for Nursing Workforce Studies

Department of State Health Services


[email protected]

TCNWS would be happy to assist you with any question or concern. The results of the 2017 Home Health and Hospice Care Nurse Staffing Study can be found at:  https://www.dshs.texas.gov/chs/cnws/Home-Health-and-Hospice-and-Long-Term-Care-Survey-Reports/.

2019 Long Term Care Nurse Staffing Study

Calling all Administrators/Directors of Nursing!

The Texas Center for Nursing Workforce Studies’ 2019 Long Term Care Nurse Staffing Study will be open through May 31st.

The purpose of this survey is to assess nurse staffing issues among employers of nurses throughout the state and to gather data that helps nursing advocates and lawmakers make informed decisions regarding the nursing shortage in Texas.

Your participation is necessary to ensure valid, reliable, and representative data are available to support recommendations and policy aimed at strengthening the nursing workforce in Texas.

Don’t miss your opportunity to make your voice heard!