In the FY 2018 Hospice Final Rule, CMS finalized the Exemption and Extension for Extraordinary Circumstances policy, (82 FR 36671). CMS-initiated waivers for exemption or extension for extraordinary circumstances that are based on FEMA-designated disasters or federally initiated public health emergencies.įor additional assistance, hospices may submit questions related to the extensions or exemption requirements to the following email address: hospice providers are required to submit HIS and CAHPS® data to CMS to comply with HQRP requirements, CMS recognizes that there are instances where an extraordinary or extenuating circumstance beyond the hospice’s control (e.g., natural disasters) may delay or prevent submission of required data.ĬMS does not want the extraordinary or extenuating circumstance to unduly increase provider burden, nor does CMS want to negatively impact a hospice provider’s annual payment update (APU) and compliance with HQRP requirements during this time.Provider-initiated requests for exemption or extension for extraordinary circumstances.This webpage provides information on two aspects of this general Exemption and Extension for Extraordinary Circumstances policy: This policy applies to both the Hospice Item Set (HIS) and the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey. You can still get home health care if you attend adult day care.This webpage provides information on the Centers for Medicare & Medicaid Services (CMS)’s Hospice Quality Reporting Program (HQRP) Exemption and Extension Policy for Extraordinary Circumstances. You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. Part-time or "intermittent" skilled nursing care You're not eligible for the home health benefit if you need more than You must be homebound, and a doctor or allowed practitioner must certify that you're.To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. Physical therapy, speech-language pathology, or continued occupational therapy services. These services are covered only when the services are specific, safe and an effective treatment for your condition.Intermittent skilled nursing care (other than drawing blood).You must need, and a doctor or allowed practitioner must certify that you need, one or more of these:.You must be under the care of a doctor or allowed practitioner, and you must be getting services under a plan of care created and reviewed regularly by a doctor or allowed practitioner.Custodial or personal care that helps you wi th daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you needĪll people with Part A and/or Part B who meet all of these conditions are covered:.Homemaker services (like shopping and cleaning) that aren’t related to your care plan. Usually, a home health care agency coordinates the services your doctor or allowed practitioner (including a nurse practitioner, a clinical nurse specialist, and physician assistant) orders for you. The home health agency caring for you must be Medicare-certified. Injectable osteoporosis drugs for women.Part-time or intermittent home health aide care ( only if you’re also getting skilled nursing care at the same time).Part-time or intermittent skilled nursing care You’re normally unable to leave your home because it’s a major effort.Leaving your home isn’t recommended because of your condition.You have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches special transportation or help from another person) because of an illness or injury.Cover eligible home health services as long as you need part-time or intermittent skilled services and as long as you’re “homebound,” which means:
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