Important Hospice Quality Reporting Program (HQRP) Updates

CMS and Swingtech posted an important HQRP update for all hospice providers. Please click here to access the complete update, and see the most critical information below:

Hospice Calendar Year (CY) 2022 data, starting on January 1, 2022, impacts Fiscal Year (FY) 2024 payments, starting on October 1, 2023—Be ready to meet the full Annual Payment Update (APU) and avoid the 4% payment reduction increase.

Beginning with FY 2024, the payment penalty increases to 4% for hospices not meeting the HQRP Requirements. To ensure hospices achieve the full APU, be certain to meet the quality reporting requirements:

  • Hospice Item Set (HIS): The threshold for HIS is 90%. This means that 90% of all HIS assessments must be submitted to and accepted by CMS within 30 days of the admission or discharge date. For HIS assessments, the quarters are based on the submission of HIS admission or discharge assessments.
  • Consumer Assessment of Healthcare Providers and Systems (CAHPS┬«): All Medicare-certified hospices that are required to conduct the CAHPS Hospice Survey must contract with an approved CAHPS Hospice Survey vendor and conduct the survey for 12 months in each calendar year. For more information about the requirements for the CAHPS Hospice Survey, please visit the survey website: www.hospicecahpssurvey.org. For CAHPS, the data collection quarters are based on patient deaths, January 1, 2022, through December 31, 2022, inclusive.
  • Claims: Administrative data are collected from claims, and hospices are considered automatically 100% compliant with submission of this data.
  • For more information on the HQRP and achieving compliance, refer to the Getting Started with the Hospice Quality Reporting Program tip sheet and other useful documents under the Best Practices webpage, or Training and Education Library webpage.

Provider-initiated requests for exemption or extension for extraordinary circumstances: If a hospice experiences an extraordinary circumstance, it can initiate a request for extension or exemption. Requests must be initiated within 90 days of the extraordinary circumstances event and must be sent to CMS via email following the instructions provided on the Extension and Exemption Requests webpage.