TITLE 26. HEALTH AND HUMAN SERVICESPART 1. HEALTH AND HUMAN SERVICES COMMISSION
HHSC is adopting the following two rules:
- CHAPTER 551.INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS SUBCHAPTER C. STANDARDS FOR LICENSURE 26 TAC §551.46-The purpose of the new rule is to describe requirements for ICF/IID Provider Response to COVID-19.
- CHAPTER 553.LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES SUBCHAPTER K. COVID-19 RESPONSE 26 TAC §553.2001– this rule requires assisted living facility actions to mitigate and contain COVID-19. The purpose of the new rule is to describe these requirements.
TITLE 26. HEALTH AND HUMAN SERVICES PART 1. HEALTH AND HUMAN SERVICES COMMISSION CHAPTER 561. EMPLOYEE MISCONDUCT REGISTRY 26 TAC §§561.1 – 561.9–
The Texas Health and Human Services Commission (HHSC) adopts new Chapter 561 Employee Misconduct Registry (EMR). The purpose of the new rules is to update and relocate the Employee Misconduct Registry (EMR) rules from 40 TAC Chapter 93 to 26 TAC Chapter 561.
Centers for Medicaid and Medicaid Services (CMS)
Renewal of Determination That A Public Health Emergency Exists
As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, CMS renewed the PHE, effective April 16, 2022. https://aspr.hhs.gov/legal/PHE/Pages/COVID19-12Apr2022.aspx.
Hospice Audit Tools
Are you aware of the various audit tools for your staff to use to ensure you are in compliance? These are just a few that you could be making use of:
- GIP: https://palmettogba.com/Palmetto/Providers.Nsf/files/Hospice_GIP_Audit_Tool.pdf/$File/Hospice_GIP_Audit_Tool.pdf.
- Hospice Record: https://palmettogba.com/Palmetto/Providers.Nsf/files/Hospice_Documentation_Audit_Tool.pdf/$File/Hospice_Documentation_Audit_Tool.pdf.
Hospice Cap/Inpatient Day Limitation Calculator
The hospice cap and inpatient day limitation calculator will assist hospice providers in calculating the hospice cap on aggregate payments and the inpatient day limitation. The purpose of the calculator is to offer assistance in monitoring payments for these limitations. The hospice cap period for both limitations is November 1 through October 31 of each year. The following sections explain further the components of this computation.
- Calculator information: https://www.palmettogba.com/palmetto/jmhhh.nsf/DID/8B4R8H1651.
- Self Determined Cap Report and Instructions: https://www.palmettogba.com/palmetto/providers.nsf/files/SDHC_2021_Form.pdf/$FILE/SDHC_2021_Form.pdf and https://www.palmettogba.com/palmetto/providers.nsf/files/Instructions_for_Completing_the_SDHC_PROFORMA.pdf/$FILE/Instructions_for_Completing_the_SDHC_PROFORMA.pdf.
Are you a new provider? Do you find yourself ever wondering if you are doing everything? Are you aware that you MUST comply with these following reporting requirements or you will receive a reduction in your per diem? A failure to report results in a percentage-point reduction to the annual payment updates (APU) for the corresponding FY. Effective with the FY 2022 Final Rule, beginning with the FY 2024 APU and for each subsequent years, the APU penalty is increased from 2% to 4% for hospices who do not comply with the HQRP for that FY. CMS has provided training and education for you to access. Please research and get “up to speed” on the Hospice Quality Reporting Program, CAHPS, and HIS. A brief overview and links are provided below.
Hospice Quality Reporting Program:
What is the HQRP?
The HQRP was established under section 1814(i)(5) of the Social Security Act. It includes data submitted by hospices through the Hospice Item Set (HIS) data collection tool, data from Medicare hospice claims, and an experience of care survey, the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey. All Medicare-certified hospice providers must comply with these reporting requirements. The timely submission and acceptance of complete data that determines compliance with HQRP requirements. Performance level is not a consideration when determining market basket updates (referred to as Annual Payment Updates (APU)). Reporting compliance is determined by successfully fulfilling both the individual requirements of HIS and CAHPS®, and the submission of administrative data (Medicare claims). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting
What is the CAHPS Hospice Survey
The CAHPS Hospice Survey is a national survey of family members or friends who cared for a patient who died while under hospice care. The survey is conducted monthly. The questionnaire contains 47 questions covering topics of interest to family caregivers and hospice patients. This information does get published on Care Compare. Go to:: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/CAHPS%C2%AE-Hospice-Survey.
What is the Hospice Item Set (HIS)
The HIS is a standardized set of items intended to capture patient-level data on each hospice patient admission. Hospices submit two HIS records (a HIS-Admission record and a HIS-Discharge record) for each patient admission occurring on or after July 1, 2014. HIS reporting consists of three primary activities: HIS data collection, HIS record conversion, and HIS record submission. For more information, go to:
National Hospice and Palliative Care Organization (NHPCO)
NHPCO shared the following:
Post Public Health Emergency Volunteer Requirements
Under the Public Health Emergency (PHE), the five percent requirement for volunteers was waived and this waiver will end once the PHE expires or is terminated. CMS is not expected to provide a ramp up period to recruit, train, and send out volunteers. The PHE is expected to be renewed through July but it is unlikely to be renewed again. This means providers should start to plan for this process now.
US Department of Health and Human Services (HHS)
ASPR has released its newsletter. You will note that they have included an update list of hurricane resources. The article on Crisis Standards of Care may be of interest to you, as well. To access the newsletter, go to: https://aspr.hhs.gov/Pages/Home.aspx.
Health and Human Services Commission (HHSC)
HHSC Updates the ALF COVID-19 Response Plan and FAQ Documents
HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents for assisted living facilities. Read the updated Frequently Asked Questions for ALFs about COVID-19: https://www.hhs.texas.gov/sites/default/files/documents/govdelivery/alf-faqs.pdf.
Providers Encouraged to Take Part in 2022 Home Health and Hospice Care Nurse Staffing Study
The Texas Center for Nursing Workforce Studies’ 2022 Home Health and Hospice Care Nurse Staffing Study is open through May 31. The survey assesses nurse staffing issues among employers of nurses throughout the state. It will help gather data so nursing advocates and lawmakers can make informed decisions about the nursing shortage in Texas. HHSC encourages directors of nursing, or other employers of nurses, to take part. This will ensure reliable and representative data are available to support recommendations and policy aimed at strengthening the nursing workforce in Texas. Here is the survey: https://www.dshs.texas.gov/chs/cnws/2022-hhhcnss/.
Medicaid Contract Processing Update from TNMHO
TNMHO is in discussions with Senators and Representatives about the problems Medicaid hospice providers are facing when initial contract applications, renewals, revalidations and change of ownerships (CHOW) are submitted. We have had some excellent and productive visits. Legislative staff are reaching out to the Health and Human Services to ascertain what the process problems are.
TNMHO will continue to represent you at the Capitol to ensure your concerns are heard, but you can help as well. We have been asked by legislative staff to remind all providers seeking a Medicaid contract and those who are renewing, revalidating or going through a CHOW to reach out to your Senator(s) and Representative(s), if problems are noted. They want to hear your story and help you to solve your problem(s).
If you don’t know who represents you, go to this link: https://wrm.capitol.texas.gov/home.
Texas Medicaid Healthcare Partnership (TMHP)
Changes to LTC Remittance and Status (R&S) Reports Information
Starting with the April 19, 2022, Remittance and Status (R&S) cycle, paid transferred (PT) and paid force transfer (PF) claims will no longer appear on R&S Reports if the date of service is older than September 1, 2019, and there have been no status updates since December 1, 2020. If a status update occurs at a later date, the claim will reappear on the R&S Report. For more information, call the LTC Help Desk at 800-626-4117.
Disclaimer: The Texas and New Mexico Hospice Organization publishes the Regulatory Update as an information only item. TNMHO has no attorneys nor does it represent the state and federal governments. All legal questions or concerns should be directed to your attorney or the governments involved.