What is a False Claims Act investigation?
What is the False Claims Act
What is the hospice governing body?
What is the governing body? In accordance with the Conditions of Participation, a Medicare certified hospice agency must have a governing body. The governing body has ultimate responsibility for the hospice agency, including legal and financial authority. Medicare...
What is the Hospice Quality Reporting Program (HQRP)?
What is the purpose of hospice quality reporting? The Affordable Care Act authorized the establishment of a Quality Reporting Program for hospices. The Hospice Quality Reporting Program (HQRP) was established in 2014. HQRP aims to ensure that the level of...
What is Hospice Item Set (HIS)?
All Medicare certified hospice agencies must submit an HIS Admission and HIS Discharge record on all admissions and discharges from their agency. The report must include all patients, irrespective of payer source, patient age, or location where hospice services were...
What is the CAHPS survey?
The CAHPS survey is intended to measure the experience of patients who had died while receiving hospice care and the experience of their primary caregivers. It surveys informal caregivers – usually family members – of the persons who died under hospice care. The...
What is a hospice PEPPER report?
Program for Evaluating Payment Patterns Electronic Reports (PEPPER) is a data analysis report that has been available for hospices since 2012. This report contains claims data statistics based upon UB-04 claims data submissions for a single hospice agency. The...
Understanding the PEPPER Report
The PEPPER report target areas focus on statistics that will identify potential for improper Medicare billing. Comparison to national, jurisdictional, and state percentiles can highlight a hospice agency’s potential need for change to its practices to guard against...
What is Hospice Visits in the Last Days of Life (HVLDL)?
HVLDL is an HQRP claims-based measure of the proportion of patients who have received in-person visits from a registered nurse (RN) or a medical social worker (MSW) on at least two of the final three days of life. This metric replaces the HIS-based measure Hospice...
What is Hospice Care Index (HCI)?
HCI is a single comprehensive metric reflecting ten indicators of care delivered during a hospice stay -- from admission to discharge. This metric, which is included in the patient Care Compare portal, is intended to provide patients, families, and caregivers...
What is the Hospice Election Statement requirement?
To receive hospice services under the Medicare benefit, a patient or his authorized representative must elect hospice care. If the patient or authorized representative elects to receive hospice care, the patient must file an election statement with a specific...