Hospice & Home Health News 2025Nov20
CMS Posts Home Health Quality and Star Rating Preview Reports for January 2026
Due to the lapse in federal appropriations, scheduled data refreshes and other routine updates were temporarily paused. With the resumption of government operations on November 13, the HHA Provider Preview Reports updates are now being released in iQIES. These reports contain provider performance scores for quality measures to be published on Care Compare in January 2026. Data contained within the Provider Preview Reports are based on quality assessment data submitted by HHAs from Quarter 2, 2024 through Quarter 1, 2025. The data for the claims-based measures will display data from Quarter 1, 2023 through Quarter 4, 2024 for the Discharge to Community and Medicare Spending Per Beneficiary measures, Quarter 1, 2022 through Quarter 4, 2024 for the Potentially Preventable 30-Day Post-Discharge Readmission measure, and Quarter 1, 2024 through Quarter 4, 2024 for the Home Health Within-Stay Potentially Preventable Hospitalization measure. Additionally, the data for the HHCAHPS measures will display data from Quarter 3, 2024 through Quarter 2, 2025. The Preview Reports for the January 2026 release include one new OASIS-based measure, COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date, based on quality assessment data from Quarter 1, 2025. This measure was proposed for removal in the CY2026 Home Health Rule which has not yet been published.
CMS Posts Hospice Quality Preview Reports for February 2026
Due to the lapse in federal appropriations, scheduled data refreshes and other routine updates were temporarily paused. With the resumption of government operations on November 13, the Hospice Provider Preview Reports are now being released on CASPER. These reports contain provider performance scores for quality measures to be published on Care Compare in February 2026. In the Provider Preview Reports, assessment-based measure scores are based on HIS data submitted by hospices from Quarter 2, 2024 through Quarter 1, 2025. CAHPS measure scores are based on CAHPS data submitted from Quarter 2, 2023 through Quarter 1, 2025. CAHPS Star Ratings are calculated based on data from Quarter 2, 2023 through Quarter 1, 2025. The claims-based measures reflect claims data collected from Quarter 1, 2023 through Quarter 4, 2024.
CMS Makes Changes to Hospice Care Index Calculations
On November 18, the Centers for Medicare and Medicaid Services (CMS) announced updates to the calculation of the Hospice Care Index (HCI) Measure. CMS identified and corrected an issue affecting how the Late Live Discharge and Early Live Discharge indicators were calculated within the HCI measure. The correction was applied to the programming logic used in calculating these indicators to ensure that each hospice’s score reflects only the care it provided to its own patients. This correction affects a small percentage of hospice providers. Archived data will be updated with the corrected methodology in a future release.
OIG Adds Home Health Outlier Payments to Their Workplan
On November 18, the Office of Inspector General (OIG) added a new item to their workplan which will look at "Incorrectly Billed Visit Units That Trigger Outlier Payments on Home Health Claims" with the objective to determine whether home health claims outlier payments complied with certain Medicare billing requirements. This work comes after previous compliance work identified claims where home health providers incorrectly billed single-discipline visit units (greater than 8 hours) that resulted in overpayments equal to the outlier payment. Medicare Administrative Contractors (MACs) pay outlier payments on home health claims for enrollees who incur unusually large costs that are determined by the visit units billed on the claim. Nationwide home health claims data for the most recent 30-month period shows that the average duration of a home health visit is 45 minutes. OIG anticipates the work on this issue to be completed by FY2027.
Home Health Weekly Recap. Here is your weekly Home Health Weekly Recap.
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