NHPCO NewsLine Winter 2021 - 32

Short
Takes
CMS News of Importance to Providers
Providers should be aware of two final rules that were published by CMS in
November that are of relevance. The NHPCO policy team provides key points of
importance pertaining to the CY 2022 Home Health Final Rule and on billing
guidance for Rural Health Clinics and Federally Qualified Health Centers.
CY 2022 Home Health Final Rule - Survey and Enforcement
Requirements for Hospices
On November 2, 2021, the Federal Register posted CMS-1747-F, the CY 2022
Home Health Prospective Payment System Rate Update Final Rule... Survey
and Enforcement Requirements for Hospice Programs.
Important changes from the proposed to final rule:
1. Suspension of all or part of payments: NHPCO advocated for this provision to
be limited to new admissions. In the final rule, CMS changed the language to
read that the suspension of payments is for new admissions only.
2. Special Focus Program: NHPCO advocated for a Technical Expert Panel (TEP)
to be convened to provide input prior to the development of any hospice Special
Focus Program. In the final rule, CMS removed the regulatory language about
the creation of the Special Focus Program and cited that revised language would
be included in future rulemaking for FY 2024.
3. Surveyor conflict of interest: NHPCO advocated for ways that CMS could
address surveyor conflict of interest. In the final rule, at 488.1110, CMS changed the
language on surveyor conflict of interest to read: " surveyors must disclose actual
or perceived conflicts of interest prior to participating in a hospice program survey
and be provided the opportunity to recuse themselves as necessary. "
CMS has also issued the QSO-22-01-Hospice memo addressing the timeline for
implementing the regulatory provisions of the CAA 2021 hospice provisions
outlined in the CY 2022 HH final rule.
The NHPCO Regulatory Team published a detailed Regulatory Alert offering
specific guidance to hospice providers. NHPCO members should download the
complete Regulatory Alert: CY 2022 Home Health Final Rule - Survey and
Enforcement Requirements for Hospices (11/08/21) from the Regulatory Alerts
and Updates page of the website.
Physicians, Nurse Practitioners and Physician Assistants in Rural Health
Clinics and Federally Qualified Health Centers can serve as a Patient's
Attending Physician when Electing Hospice
After many years of advocacy, physicians and non-physician practitioners who
work in Rural Health Clinics (RHCs) and Federally Qualified Health Centers
(FQHCs) can, as of January 1, 2022, serve as a hospice patient's attending
physician and receive payment for their services. The CY 2022 Physician Fee
Schedule final rule published the
change. CMS has issued CR 12357
and MM 12357 announcing the use of
the GV modifier for RHCs and
FQHCs. Beginning January 1, 2022,
an RHC or FQHC can bill and get
payment under the RHC All Inclusive
Rate or FQHC Prospective Payment
System, respectively, when their
employed and designated attending
physician provides services during a
patient's hospice election. To get the
RHC AIR or payment under the FQHC
PPS:
▌ RHCs must report the GV modifier
on the claim line for payment each
day they provide a hospice
attending physician service.
FQHCs must report the GV modifier
on the claim line with the payment
code (G0466 - G0470) each day they
provide a hospice attending physician
service. This applies when a physician,
nurse practitioner, or physician
assistant working for or under
contract to an RHC or FQHC
provides hospice attending physician
services to a Medicare patient who
has elected hospice.
NHPCO members will find all of
the Regulatory and Policy
Alerts available in the
Regulatory Alerts & Updates
section of the website at
nhpco.org/regulatory.
32
Newsline / Winter 2021

https://www.cms.gov/files/document/r11095cp.pdf https://www.cms.gov/files/document/mm12357-implementation-gv-modifier-rural-health-clinics-rhcs-and-federally-qualified-health-centers.pdf https://public-inspection.federalregister.gov/2021-23993.pdf https://www.cms.gov/files/document/qso-22-01-hospice.pdf https://www.nhpco.org/regulatory-and-quality/regulatory/updates/ https://www.nhpco.org/regulatory-and-quality/regulatory/updates/ http://www.nhpco.org/regulatory

NHPCO NewsLine Winter 2021

Table of Contents for the Digital Edition of NHPCO NewsLine Winter 2021