CMS Open Door Forum Addresses Home Health CAHPS

The Centers for Medicare & Medicaid Services proposed to discontinue the HHABN (CMS-R-296) and require home health agencies to use the Advance Beneficiary Notice to notify beneficiaries of Medicare non-coverage (Form CMS-R-131). In addition, a new Home Health Change of Care Notice (HHCCN) has been created to notify beneficiaries of changes of care (Form CMS-10280), which is now accomplished through Option box 2 and 3 of the HHABN. CMS is seeking public comments on these proposals.

Home Health CAHPS

An update was provided on Home Health Consumer Assessment of Healthcare Providers and Systems. Agencies were advised that they must file for a HH CAHPS participation exemption for 2014 by Jan. 17, 2013 if they served 59 or fewer patients between April 2011 and March 2012 that meet CAHPS requirements. CMS expects that very few patients are exempted from CAHPS based on the “no publicity” policy as this exemption is generally limited to high profile and famous individuals. Unlike “no publicity” patients, respondent refusals are not included as exempted patients.

Introductory vendor training, which is open to home health agencies, is scheduled for Jan. 28, 2013 and Jan. 29, 2013. On Jan. 30, 2013 update training will be provided for all current vendors. Registration is open through Friday, Jan. 11, 2013.

Home Health Compare will be updated on Jan. 17, 2013 to reflect July 2011 through June 2012 CAHPS data. In addition, Jan. 2013 is the date that 3rd quarter 2012 CAHPS data must be submitted. Providers were reminded that data is posted only after an agency has submitted four full quarters of date. Also, new providers were reminded to authorize a vendor to submit their data, and participating providers were reminded to continuously check to ensure that their vendors are submitting their data timely. Agencies should notify their vendors immediately if they have problems submitting data to ensure that their vendor submits a discrepancy notification form to CMS.

See home page for details about all of the above

Home Health Study Regarding Access to Care

Affordable Care Act mandated a study on access to home health care to low income beneficiaries, beneficiaries in underserved areas, and those with certain conditions. As part of this study, two surveys are being conducted. Next week, 1,075 home health agencies and 510 referring physicians will receive these surveys in the mail. CMS urged participation by agencies and physicians.

Home Health Quality Reporting

Home health agencies may access quality information at CMS recently revised three home health manuals as follows:

  • Annual update to the OASIS-C guidance manual was posted on Dec. 13, 2012 with revisions and an errata sheet can be found by clicking here
  • Revised OASIS PBQI manual was posted on Dec. 14, 2012 in the Downloads at OASIS PBQI/PROCESS MEASURES
  • Revised OBQI Manual was posted in Downloads at OASIS OBQI

The Jan. 17, 2013 update to Home Health Compare will reflect claims based acute care hospitalization and emergency department use data.

Home Health Grouper

A retroactive grouper change has been made to restore basal cell, squamous cell, and unspecified malignant cancers to the grouper. These 173 skin cancer points were erroneously left out of the grouper for services rendered Oct.1, 2011 through Dec. 31, 2012. CMS will require home health agencies to refile claims for patient with these diagnoses in order to receive the corrected payment. These corrected claims will not be subject to timely filing. Home health agencies will receive instructions from their Medicare Administrative Contractors (MAC), through their MAC websites or other means of notification, about how to resubmit affected claims and receive underpayments.

OASIS Training

CMS’ OASIS web-based training has been updated with three new OASIS training modules. OASIS training modules are focused on entry level employees. The modules can be accessed at (click on “I am a Provider > click on web-based training > click on Outcome and Information Set training (OASIS) > then click on Launch course). The three new program domains are Patient Tracking, Clinical Record, and Elimination Status. Additional training modules will be released over the next several months. The modules include power point presentations and post tests. Feedback is welcomed and will be incorporated as changes in guidance made.

Flu Vaccination

Participants were reminded that it is flu season and that Medicare pays for flu vaccine and administration to Medicare beneficiaries. Also, participants were reminded to obtain flu vaccines for themselves and their families.


Questions were raised as to changes in home health plans for a moratorium on new providers and the status of activation of PECOS edits. CMS staff responded that there is no new information on either issue.

An encore of this Open Door Forum is available at: Encore: (855) 859-2056 using the conference ID 78868196.

Questions about home health, hospice, and DME issues can be emailed to

The next Open Door Forum is Feb. 20, 2013 at 2:00pm ET.

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