The HIS is a standardized set of items intended to capture patient-level data on each hospice patient admission. HIS items can be used to calculate eight National Quality Forum (NQF)–endorsed measures, and one non-NQF endorsed measure (
What are the his requirements and reporting years for hospitals?
1.3 HIS Requirements and Reporting Years Hospices shall 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.
What is the purpose of the his report?
Disclaimer: The HIS is intended for use in quality reporting; it does not imply acceptability for payment purposes. SECTION I: RATIONALE Disease processes and conditions can impact service delivery. This section includes the most common principal diagnoses among hospice patients. I0010.
When should I include the patient’s Medicare number on the record?
• If the hospice is notified after the record has been submitted that the patient does have a Medicare number, include it on the next record. For instance, if the Medicare number is received after submission of the HIS-Admission record, include the patient’s Medicare number on the HIS -Discharge record.
Will changes to his data affect the current provider preview report?
However, any modifications made to HIS data on or after the Hospice Provider Preview Report Data Correction Deadline will only be reflected in subsequent Provider Preview Reports and Care Compare refreshes. These changes will not affect the current Provider Preview Report or the related Care Compare Refresh.
What is his documentation?
The HIS is a standardized set of items intended to capture patient-level data on each hospice patient admission.
What is a his report in hospice?
The HIS is a set of data elements that can be used to calculate 7 quality measures – 6 NQF-endorsed measures and 1 modified. NQF-endorsed measure: • NQF #1641 – Treatment Preferences. • Modified NQF #1647 – Beliefs/Values Addressed. • NQF #1634 & NQF #1637 – Pain Screening and Pain Assessment.
What are CMS reports?
The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).
What are the CMS Quality Measures?
These goals include: effective, safe, efficient, patient-centered, equitable, and timely care.
What is the purpose of CMS reporting?
The purpose of Section 111 reporting is to enable CMS to pay appropriately for Medicare-covered items and services furnished to Medicare beneficiaries.
What is CMS quality based reporting?
Under the Hospital Inpatient Quality Reporting Program, CMS collects quality data from hospitals paid under the Inpatient Prospective Payment System, with the goal of driving quality improvement through measurement and transparency by publicly displaying data to help consumers make more informed decisions about their ...
What does CMS stand for?
The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS).
What are the 4 core measures?
These measures specify best clinical practice in four areas: Heart Failure, Acute Myocardial Infarction (AMI, i.e. Heart Attack), Pneumonia, and Surgical Site Infection prevention. Health organizations' performance on the Core Measures is assessed by examining documentation in patients' medical records.
What is quality reporting healthcare?
Quality measures are standards for measuring the performance and improvement of population health or of health plans, providers of services, and other clinicians in the delivery of healthcare services.
What are CMS core measures?
Core measures are national standards of care and treatment processes for common conditions. These processes are proven to reduce complications and lead to better patient outcomes. Core measure compliance shows how often a hospital provides each recommended treatment for certain medical conditions.
When will the HIS data submission specifications be released?
This FINAL version of the specifications will go into effect on April 1, 2019. This version of the data specifications consists of the following files:
What is errata v2.02.2?
Errata v2.02.2 for the FINAL version of the Hospice Item Set (HIS) data submission specifications (V2.02.1) is now available. This errata contains one issue, which is the addition of MP as a valid value for the item STATE_CD. This change is retroactive to April 1, 2017 and will be implemented in production on August 1, 2020.
When are cost reports due for Medicare?
Cost reports are due five months after the fiscal year end. Any delays are subject to withholding of Medicare reimbursement. Facilities will try to use these cost reports to maximize legal reimbursement by ensuring correct filing and reporting of fiscal data. Facilities with low or no Medicare utilization need to submit a low-utilization cost ...
What is CMS in Medicare?
Centers for Medicare and Medicaid Services (CMS), the United States government organization in charge of Medicare, regulates the specific requirements for these reports. [ 2] Medicare cost report software is strictly monitored to be CMS-compliant so that reports will be accurate and fulfill all requirements.
What is the RHC cost report?
The RHC cost report determines the rate per covered visit for every Medicare visit and how much reimbursement is owed to/ from the facility. The Medicare cost report also determines if there are is any reimbursement due to or from the facility. For facilities paid via PPS, there still may be reimbursement for bad debt or vaccines.
What is chapter 1 of the HIS?
Chapter 1 – Provides an introduction of contextual information, timing and sequence policies, and general guidance. Chapter 2 – Contains item-specific guidance for completing each item in the HIS. Chapter 3 – Includes information on HIS record submission and correction processes.
What is the OMB number?
The valid OMB control number for this information collection is 0938-1153.
How long does it take for hospice to get a quality measure?
Hospices will have 30 days to preview their HIS quality measure results beginning on the date that CMS makes the reports available. Should the hospice provider believe the denominator or other quality metric to be inaccurate, a provider may request a CMS review of the calculations contained within the HIS Provider Preview Report.
How long can hospices keep inactive records?
Hospices can still submit HIS modification and inactive records for up to 24 months after the target date; however, the corrections submitted after the Hospice Provider Preview report freeze date will not be reflected until the next Preview Report is generated. For details on dates: see the Hospice Public Reporting Key Dates table on ...
When will hospice data freeze?
Further, public reporting of hospices’ data will freeze after the November 2020 refresh. This means that following the November 2020 refresh, CMS will hold the publicly reported data constant through the November 2021 refresh. Additionally, CMS will not issue Provider Preview Reports for those refreshes that continue to display ...
Does CMS review HIPAA requests?
CMS will not review any requests that include protected health information (PHI) or other Health Insurance Portability and Accountability Act (HIPAA) violations in the request being submitted to CMS for review. Hospice Quality Reporting Program Archives.
Does CMS accept hospice reports?
CMS will not accept any requests for review of measure results that are submitted after the posted deadline, which falls on the last day of the preview period. Hospices are required to submit their request to CMS via email with the subject line: “ [Provider Name] Hospice Public Reporting Request for Review of HIS Measure Results” and include ...
What is a casper report?
The CASPER Reporting application enables hospice providers with a Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing (ASAP) User ID to connect electronically to the National Reporting Database. Currently, there are several CASPER reports available for hospice providers. CASPER reports can help hospice providers monitor the status of the HIS records submitted to the QIES ASAP system. Current CASPER reports allow providers to track HIS record status and determine when correction of errors, should they be present, is needed. On July 17, 2016, CMS released the Hospice Timeliness Compliance Threshold Report, which is a CASPER report that allows providers to check their preliminary compliance with the 70/80/90 compliance threshold. Specifically, this report will display:
When does the CMS E6.D go into effect?
These policies go into effect for the FY 2018 reporting year, which begins January 1, 2016.