Federal Home Health and Hospice Update
(June 3, 2025) Please see recent home health and hospice news from LeadingAge National:
LeadingAge WIN: Final Data Collection Specs on MA Coverage and Payment Respond to LeadingAge-Articulated Concerns. On May 30th, the Centers for Medicare and Medicaid Services (CMS) published a notice related to the final details of its Medicare Advantage (MA) data collection initiative related to both coverage and payment determinations. This data collection will occur annually and be submitted by plans, providing a wealth of insights into MA plan compliance with Medicare coverage requirements and other policies. It will also show which services are denied the most for prior authorization, concurrent review, or payment. LeadingAge National is pleased to see that many of the concerns they outlined in a comment letter on the initial proposal in 2024 were addressed in this final draft. Further details and links to the Federal Register notice and CMS technical specifications document can be found in this LeadingAge National article.
LeadingAge Endorses Prior Authorization Bill. LeadingAge National has once again endorsed the recently reintroduced prior authorization bill, Improving Seniors’ Timely Access to Care Act (H.R. 3514/S. 1816), and LeadingAge NY will also be signing on. The bipartisan bill currently boasts support from 48 senators and 73 House members, along with more than 160 endorsing organizations, but the Regulatory Relief Coalition, which has been leading the work on this bill, is looking to demonstrate a groundswell of support again for the legislation.
LeadingAge and Hospice Associations Ask CMS to Delay HOPE Implementation. LeadingAge National, along with the National Alliance for Care at Home and the National Partnership for Healthcare and Hospice Innovation, sent a letter to CMS Administrator Dr. Mehmet Oz asking for a delay in the implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool. The May 19th letter outlines the concerns with technology implementation in preparation for the HOPE tool. The letter specifically asks CMS to waive the HOPE timeliness submission requirement for two calendar quarters post implementation. Further, the letter requests that CMS delay the HOPE implementation date until at least six months after CMS education, training, and final validation specifications are available and the application for Internet Quality Improvement and Evaluation System (iQIES) access has been opened for hospices.
CMS Issues Updates to HOPE Guidance: Key Changes Hospices Need to Know. CMS released an updated HOPE manual which made changes to several key items and made guidance updates that hospices should understand. LeadingAge National has laid out key elements of these guidance changes that you need to know as you work to implement the HOPE tool in your hospice.
Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871