Home Health and Hospice Nationwide Moratorium Q & As

Program: Home Health, Hospice

CMS has issued a Q&A regarding the Home Health and Hospice nationwide moratorium implemented on May 13, 2026. This moratorium is for 6 months.

CMS Implements Nationwide Moratorium for Home Health and Hospice

Program: Home Health, Hospice

On May 13, 2026, CMS implemented a nationwide enrollment moratorium for Home Health and Hospice agencies. This moratorium applies to initial applications.

CMS Phasing out Fax and Mail Streamlining Electronic Transactions

Program: Acute Care Hospital, Ambulatory Care, Ambulatory Surgical Centers (ASC), Clinical Laboratory, Critical Access Hospital, DMEPOS, Home Health, Home Infusion Therapy, Hospice, Pharmacy, Renal Dialysis

CMS, via the Administrative Simplification Rule, will be phasing out fax and mail related to claims activity. This rule becomes effective May 26, 2026, and provides covered entities 24-months to becomes compliant (by May 26, 2028).  For more info, continue to read the final rule fact sheet.

CMS Updates Fee-for-Service Advanced Beneficiary Notice of Noncoverage Form

Program: DMEPOS, Home Health, Home Infusion Therapy, Hospice

The Advanced Beneficiary Notice of Noncoverage form has been updated as of March 13, 2026. The form number is CMS-R-131. Providers may begin using this form immediately. The expired version may still be used through May 12,2026.

California LVN Scope of Practice Update

Program: Home Care, Home Health, Hospice

On Oct 1, 2025, the California Respiratory Care Board adopted regulations that impact the scope of practice for LVNs.  Read more for a summary of the impact of these changes on LVN practice in California.

Texas House Bill 4224 Updates Medical Records Privacy Provisions

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

In May 2025, Texas passed House Bill 4224 which provided updates to Texas Health and Safety Code Chapter 181. These updates were effective September 1, 2025. Agencies/Organizations should review policy and practices to ensure compliance.

Termination of Designation of Somalia for Temporary Protective Status

Program: Home Care, Home Health, Hospice

A notice was posted to the Federal Register on January 15, 2026, by DHS US Citizenship and Immigration Services regarding the Temporary Protected Status for Somalia. The designation of Somalia for Temporary Protected Status will be terminated March 17, 2026, 11:59pm local time.

CLIA: Going paperless March 1, 2026

Program: Clinical Laboratory, Home Health, Hospice

Effective March 1, 2026, paper fee coupons and CLIA certificates will no longer be available.  Providers will need to be sure they have signed up to switch to paperless to avoid any disruptions.

Termination of the Designation of Haiti for Temporary Protected Status

Program: Home Care, Home Health, Hospice

A notice was posted to the Federal Register on 11/28/2025 by DHS US Citizenship and Immigration Services regarding the Temporary Protected Status for Haiti. The designation of Haiti for Temporary Protected Status will be terminated February 3, 2026, 11:59pm local time.

Medicare – Update on Processing of Telehealth and Acute Hospital Care at Home Claims

Program: Acute Care Hospital, Behavioral Health, Critical Care Hospital, Home Health, Home Infusion Therapy, Hospice, Renal Dialysis

In the absence of Congressional action, beginning October 1, 2025, many of the statutory limitations on payment for Medicare telehealth services that were, in response to the COVID-19 Public Health Emergency, lifted and subsequently extended through legislation again took effect. These statutory limitations include restrictions on payment for many telehealth services provided to beneficiaries in their homes and outside of rural areas, and the provision of hospice recertifications that require a face-to-face encounter via telehealth. These limitations are not applicable to all Medicare telehealth services, such as those for behavioral and mental health services, those for monthly ESRD-related clinical assessments, and those provided by applicable Medicare Shared Savings Program Accountable Care Organizations (ACO) participants.

CMS has been continuously evaluating our operations since October 1, 2025, and taking action when operationally feasible. To date, to ensure that CMS pays only the telehealth claims consistent with current law, CMS has instructed the Medicare Administrative Contractors (MACs) to pay telehealth claims with dates of service on and after October 1, 2025, when CMS can definitively confirm that the claims are for behavioral and mental health services or otherwise meet the requirements described at Section 1834(m) of the Social Security Act. CMS has identified these claims using the list of HCPCS codes identified in Table 1. Additionally, we have instructed the MACs to process Medicare telehealth claims with a place of service code 10 (patient’s home) that contains a diagnosis code in the F01.A0-F99 range if the services were not performed by physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), or audiologists. We have further released a small batch of other telehealth claims that we can identify should be permissible to pay under current law.

However, due to systems limitations and recognizing that not all telehealth claims for behavioral and mental health services necessarily include a diagnosis code in the above range – often to further protect the privacy of the patient – we have not been able to identify all claims that are payable under current law. These limitations have also impacted our ability to identify telehealth services performed by clinicians in applicable Medicare Shared Savings Program ACOs, who may receive payment for covered telehealth services to certain Medicare beneficiaries without geographic restrictions, including in the beneficiary’s home, per section 1899(l) of the Social Security Act as added by the Bipartisan Budget Act of 2018 (Pub. L. 115-123). To date, this subset of telehealth claims, including those submitted by clinicians in applicable ACOs and those that we’re not able to identify as for behavioral and mental health services, has been held.

To resolve this subset of claims and improve cash flow for practitioners, CMS is taking further action. For the subset of telehealth claims that are currently being held, and that were submitted on or before November 10, 2025, with dates of service on or after October 1, 2025, CMS will be returning those claims to providers. For professional claims, claims will be returned with the following messages: CARC 16 and RARC M77. Practitioners may resubmit returned claims that meet the statutory requirements.

See the spotlight on the All Fee-for-Service Providers webpage for information on statutory requirements and revised instructions for the submission of telehealth claims.

Texas HHSC Updates General FAQs for HCSSAs

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services Commission has provided an update to their General FAQs for Home and Community Support Services Agencies.  The most current version is dated August 2025.

CY 2026 Hospice Final Rule Released

Program: Hospice

On August 1, 2025, CMS released the FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule.  In this final rule, CMS provides updates to the payment rate, Hospice Quality Reporting Program, and Conditions of Participation. Hospice providers should familiarize themselves with these updated provisions which become effective October 1, 2025.

CMS: Fast Facts for Hospice

Program: Hospice

CMS published a Fast Facts for Hospice outlining recent utilization and expanded oversight to combat fraud, waste, and abuse.

CMS Issues Waivers for Texas Flood Impacted Areas

Program: Acute Care Hospital, Durable Medical Equipment and Supplies, Home Care, Home Health, Hospice, Renal Dialysis

CMS declared a public health emergency for the State of Texas on July 8, 2025, allowing the Secretary to issue 1135 waivers to provide flexibility and support for Texas providers. These waivers are effective retrospectively to July 2, 2025. CMS has updated their website to include information related to the waivers as well as additional resources for the impacted areas.

CDPH All Facilities Letter 25-19 Updates Application Process

Program: Home Care, Home Health, Hospice

On June 26, 2025, California Department of Health issued AFL 25-19 to all facility types.  This provider letter outlines changes in the application process effective July 1, 2025. These changes include application fees and denials of incomplete licensing application packets.

Revised CMS-855A- Institutional Providers for CMS enrollment

Program: Acute Care Hospital, Home Health, Hospice, Renal Dialysis

Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application

Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply with the 2023 Final rule in reporting ownership, management and related party data. Starting 10/1/2024, all SNF providers must only submit the revised form CMS-855A (09/24). For all other Part A provider types, you must use the revised form CMS-855A (09/24) starting 12/1/2024.

The CMS website has information to assist with the attachment section and will post updates for guidance:

• Guidance for SNF attachment on Form CMS-855A
• Become a Medicare Provider or Supplier

Other Related Content

• MLN Connects® Newsletter: September 19, 2024, Skilled Nursing Facilities: Report Your Expanded Ownership, Management, & Related Party Data
• NGS website for Part A provider visit Enrollment for articles about submitting an application.
• Provider Enrollment, Chain, and Ownership System (PECOS) SNF Attachment 1 Workflow, for instructions see SNF Attachment 1 workflow

Texas HHSC Reminds Regulated Providers to Update Emergency Preparedness Plans for Hurricane Season

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

AUSTIN – The Texas Health and Human Services Commission is urging health care facilities, child care operators and other providers to update their safety procedures and emergency response plans as the 2025 Atlantic hurricane season begins on June 1.

The National Oceanic and Atmospheric Administration forecasts a range of six to 10 hurricanes in the Atlantic Ocean this season. Of those, three to five are expected to be major hurricanes of Category 3 or higher. An average Atlantic hurricane season has three major hurricanes.

“We’ve seen the dangerous and sometimes deadly consequences of severe weather in Texas,” said Stephen Pahl, deputy executive commissioner of HHSC Regulatory Services Division. “That’s why it’s so important to have a current emergency preparedness plan that staff can implement quickly and effectively to protect vulnerable clients.”

HHSC requires long-term care providers such as nursing facilities, assisted living facilities, hospices and state-regulated group homes to regularly prepare for natural disasters, including hurricanes and flooding. HHSC also requires child care operations and acute health care facilities such as hospitals and dialysis centers to maintain an updated plan and ensure staff are fully trained to implement it during a crisis.

A provider’s emergency plans for extreme weather should address:

• Power loss.
• Water and food needs.
• Communication to families and staff.
• Staff shortages and responsibilities.
• Continuation of care and treatment for individuals.
• Sheltering in place, evacuation and transportation, as applicable.
• Facilities with generators should perform any maintenance or needed testing to ensure the equipment functions during a power loss.

HHSC issues guidance to providers about updating their plans and encourages them to visit the Department of State Health Services Texas Ready website for hurricane preparedness resources, including sample plans, supply checklists and other information on emergency preparedness.

The Atlantic hurricane season, which affects the Texas Gulf Coast, continues through Nov. 30.

About HHSC Disaster Services

In the event of an emergency, HHSC Disaster Services provides public health and medical support, shelters for people with medical needs, counseling services, disaster food assistance and water and ice. The program also provides regulatory support for health care facilities, long-term care facilities and child care operations, and special waivers for Medicaid providers and clients as needed.

Hospice FY26 Proposed Rule: Correction Made to the Document

Program: Hospice

CMS published a correction to the CMS Hospice FY26 Proposed Rule May 21, 2025.  This correction appears to correct the date of deadline for public comments from June 30, 2025, to June 10, 2025. Both the original document and correction are available for viewing on the Federal Register.

Texas HHSC Approves New Process

Program: Hospice

Texas HHSC has approved a new process for the authorization of digital signatures for Hospice Form 3071, Individual Election, Cancellation, or Update and Form 3074, Physician Certification of Terminal Illness.  The new rules outline acceptable methods of technology for digital signature.

OIG Report: Improper Payments

Program: Acute Care Hospital, Hospice

The Office of Inspector General released a report that Medicare improperly paid acute care hospitals for outpatient services provided to hospice enrollees. Both hospices and acute care providers are encouraged to understand the findings of the report and how provider processes may impact this issue.

Hospice Claims Edits for Certifying Physicians

Program: Hospice

CMS has updated MLN Matters Number MM13531.  This MLN assists providers in understanding edits on hospice claims related to Hospice Certifying Physician Medicare Enrollment requirements.  Providers are also encouraged to review their MAC’s websites as well for any additional instructions.

Florida – All Provider Types UPDATE: Hurricane Debby – Key Medicaid Information for Fee-for-Service and Managed Care Providers

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Clinical Laboratory, Critical Care Hospital, Durable Medical Equipment and Supplies, Home Care, Home Health, Home Infusion Therapy, Hospice, Pharmacy, Renal Dialysis, Sleep

The purpose of this alert is to provide an update to the previous provider alert issued on 08/04/2024 regarding Hurricane Debby.

The following flexibilities/waivers offered to providers in the alert issued on 08/04/2024 will expire at 11:59 p.m. on Tuesday, September 3, 2024:

• Waiver of prior authorization requirements for critical Medicaid services
  • The lifting of early prescription refill edits will remain in place in accordance with Governor Ron DeSantis’ emergency executive orders issued for Hurricane Debby
• Waiver of service limitations to ensure a recipient requiring critical Medicaid services during the storm receives such care
• Temporary postponement of the Preadmission Screening and Resident Review processes

Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1- 877-254-1055

CMS Releases Hospice HOPE Resources

Program: Hospice

CMS has recently updated the CMS HOPE website with resources to help Hospice agencies prepare for implementation of the new HOPE assessment instrument which will be effective October, 1 2025.  These updated resources include the finalized HOPE manual, data that will be collected at the required time points, and an all-item set change table to help agencies educate staff on changes from the current HIS items set items to the new HOPE items.  Read more on the CMS HOPE website about these important changes that will be coming.

CMS Releases FY26 Hospice Proposed Rule

Program: Hospice

On April 11, 2025, CMS released the FY26 Hospice Wage Index and Payment Rate Update Proposed Rule.  Updates include annual rate setting updates, requests for information, and minor updates to the CoPs and HQRP.

Texas Home and Community Support Services Agencies – FAQs Updated

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services updated the FAQ document for Texas Home and Community Support Services Agencies (HCSSAs).  The most current version is dated April 2025.  Updates include emergency communication system sign up requirements (AlertMedia) and use of the Critical Incident Management System (CIMS) for reporting abuse, neglect, and exploitation.

Hospice Special Focus Program Ceased

Program: Hospice

Effective February 14, 2025, implementation of the Hospice Special Focus Program for CY 2025 has ceased so that CMS may further evaluate the program. Please contact QSOG_Hospice@cms.hhs.gov for policy questions.

Medicare Telehealth Flexibilities Extended through March 31, 2025

Program: Home Health, Hospice

Congress recently passed a bill that will allow for certain telehealth flexibilities to extend until March 31, 2025.  This includes the ability to perform telehealth Face to Face encounters for home health and hospice.  We will continue to monitor for further developments.

Medicare Telehealth Flexibilities Extended through September 30, 2025

Program: Home Health, Hospice

Congress enacted a government funding package that included a 6-month extension of current Medicare telehealth waivers through September 30, 2025,

Texas HHSC PL 2025-01: New Emergency Communication Tool – AlertMedia

Program: Assisted Living, Home Care, Home Health, Home Infusion Therapy, Hospice

On January 7, 2025, Texas Health and Human Services Commission issued Provider Letter 2025-01 New Emergency Communication Tool – AlertMedia.  The provider letter is applicable to all providers in the Long-Term Care division including hospices, home and community support services, and assisted living facilities.  Providers should review this provider letter for policy details and provider responsibilities.  Provider responsibilities must be met no later than February 15, 2025.

Texas HHSC Rescinds PL 2024-20 Requirements for Tuberculosis Screening and Testing

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

On November 1, 2024, Texas HHSC rescinded Provider Letter 2024-20 Requirement for Tuberculosis Screening and Testing.  During the interim, providers are to follow agency procedures regarding communicable diseases, infection control, and TB testing/screening.  Texas HHSC recommends agencies utilize resources from the CDC and Texas Department of State Health Services to inform the agency’s policies and procedures (links provided).

CMS Home Health and Hospice Resources November 2024

Program: Home Health, Hospice

Medicare covers a wide range of home health and hospice services. During Home Care & Hospice Month, get familiar with these Medicare Learning Network resources.

California Assembly Bill 177 Extends Hospice Licensure Moratorium

Program: Hospice

On September 30, 2024, California Assembly Bill 177 was chaptered.  This bill extends the deadline, from January 1, 2025, to January 1, 2026, for the Department to adopt emergency regulations related to Hospice.  This extension also extends the Hospice licensure moratorium until January 1, 2027, or one year after the date the emergency regulations are adopted.  The emergency regulations the Department are to implement include establishing requirements for office space, staffing ratios, management personnel, and geographical service areas.

CMS: Introducing the Hospice Outcomes & Patient Evaluation (HOPE) Tool

Program: Hospice

CMS has released web-based training on the new Hospice Outcomes and Patient Evaluation (HOPE) tool.  While the HOPE tool will not be utilized until 2025, agencies should begin learning about the HOPE tool and preparing for the transition from HIS to HOPE data collection and reporting.

CMS Updates Hospice Certifying Enrollment Q&A Document

Program: Hospice

CMS updated the Hospice Certifying Physician Enrollment Q&A document.  The most current version of this document is dated September 19, 2024.  Hospice providers are encouraged to review this document to ensure compliance with CMS requirements.

Expanded Prepayment Review of Existing Hospices in Arizona, California, Nevada, & Texas

Program: Hospice

CMS has issued and MLN fact sheet related to expanded prepayment review and related activities for existing hospice providers in Arizona, California, Nevada, & Texas.

Kentucky – Training requirements for personnel who care for Alzheimer’s patients

Program: Home Health, Hospice, Private Duty

The purpose of this section is to set minimum training requirements for direct- care staff members that are employed by facilities or programs regulated by the cabinet that provide services to individuals who exhibit symptoms of Alzheimer’s disease or other dementias in the populations they serve.

KY S 61

3

Hospice Benefit: Expanding Prepayment Review in 4 States

Program: Hospice

To combat fraud, waste, and abuse under the hospice benefit, CMS will expand prepayment medical review this September in Arizona, California, Nevada, and Texas. To help reduce burden on compliant providers, initial review volumes will be low and adjusted based on results.

If you’re noncompliant, we may implement extended review or take additional administrative actions.

CMS FY 2025 Hospice Final Rule

Program: Hospice

On July 30, CMS released the FY 2025 Hospice Wage Index and Payment Rate Update, Hospice CoP Updates, and Hospice Quality Reporting Program Updates.  This is scheduled to be published in the federal register August 6, 2025.  Changes outlined in this final rule will be effective Oct 1, 2025, unless otherwise stated.  This final rule addresses payment, quality reporting, CAHPS, the new HOPE instrument, and CoP updates.

Hospice Certifying Physician Enrollment Requirement – CMS Q&A

Program: Hospice

On June 6, 2024, CMS published a Q&A document related to enrollment requirements for hospice certifying physicians which went into effect June 3, 2024.  CMS notes in the document that the policies in the Q&A document supersede the MLN issued on March 26, 2024, with regards to any possible inconsistencies.

CMS Updates the State Operations Manual Appendix M – New L Tags

Program: Hospice

On May 28, 2024, CMS issues memo QSO-24-12 Hospice & FQHC/RHC.  In this memo, CMS provided updates to the State Operations Manual Appendix M.  This update issues the L tags related to Marriage and Family Therapists and Mental Health Counselors.  This update was effective immediately.

MLN Fact Sheet Updated – Period of Enhanced Oversight for New Hospices

Program: Hospice

CMS issued an updated MLN Fact Sheet recently to include that a hospice that is reactivated after being deactivated will be considered a new hospice and thus subject to the period of enhanced oversight for new hospices.  This MLN is applicable to hospices in Arizona, California, Nevada, and Texas.

California ALF – Hot Summer Weather Advisory

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

​All Facilities Letter Summary

• This AFL reminds health care facilities to implement recommended precautionary measures to keep individuals safe and comfortable during extremely hot weather.
• Facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications.
• Facilities must report extreme heat conditions that compromise patient health and safety and/or require an evacuation, transfer, or discharge of patients.

State Operations Manual (SOM) Appendix M – Hospice Update 5-28-2024

Program: Hospice

On May 28, 2024, CMS issued memo QSO-24-12-Hospice & FQHC/RHC.  This memo includes an advance copy of updates to the State Operations Manual for Hospice.  This memo includes the addition of two new L tags related to the recent addition of the Marriage & Family Therapist and/or Mental Health Counselor to the interdisciplinary team.

Update: Hospice Certifying Physician Enrollment Requirements Effective Date Delayed until June 3, 2024

Program: Hospice

Update:  CMS issued a revised MLN on April 25, 2024 that states the effective date of this requirement has been delayed until June 3, 2024.

Reminder to all hospice providers: Effective May 1, 2024, hospice certifying physicians (Medical Director, Medical Director designee, and/or interdisciplinary team hospice physician, as well as the patient-designated attending physician, if they have one) must be enrolled in Medicare or validly opted out at the time of the certification.  It is imperative that hospice providers understand this requirement in order to determine processes for billing compliance.  Read more to learn about the important concepts of this new requirement.

Texas Provider Letter 2024-06 Teleservices in HCSSAs

Program: Home Care, Home Health, Hospice

Texas Health and Human Services Commission issued Provider Letter 2024-06 April 3, 2024.  This provider letter is applicable to Home and Community Support Services Agencies and provides guidance for those agencies who provide teleservices.

Fiscal Year (FY) 2025 Hospice Payment Rate Update Proposed Rule

Program: Hospice

On March 28, 2024, CMS issued the FY 2025 proposed rule.  This proposed rule addresses payment updates, hospice quality reporting, and additional proposed regulations.  See the CMS newsroom fact sheet for more information.

CMS Updates Hospice Model Election Statement

Program: Hospice

CMS has released an updated Hospice Model Election Statement.  The updated model form is dated March 2024.  Note that the requirements for the Hospice Election Statement and Addendum have not changed.  Updates to the sample Hospice election statement reflect changes enacted in prior final rules.  The hospice model Addendum to the election statement has not yet been updated.

Hospice Value-Based Insurance Design Model Ending This Year

Program: Hospice

On March 4, 2024, CMS announced the Hospice Value-Based Insurance Design (VBID) Model, which allowed participating Medicare Advantage Organizations (MAOs) to include the Medicare hospice benefit in their Medicare Advantage (MA) benefits package, is ending with the calendar year.

Florida Providers – Licensure Renewal Application Process Revised

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Assisted Living, Behavioral Health, Clinical Laboratory, Home Care, Home Health, Home Infusion Therapy, Hospice

Pursuant to Florida Rule 59A-35.060, effective March 5, 2024, all providers will be required to submit renewal applications through AHCA’s online licensing system.

Texas Home and Community Support Services Agencies – Updated FAQs

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services Commission has updated the FAQs for Home and Community Support Services Agencies.  The most recent version is February 2024.

Texas Home and Community-based Services Billing Requirements Updated

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services recently issued a revision to the program billing requirements for home and community-based services providers.  The update is revision 24-1 and was effective January 1, 2024.  Make sure you have the latest version.

Texas Provider Letter PL 2024-05 – Administrator and Alternate Administrator Requirements for HCSSAs

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services issued provider letter PL 2024-05 February 8, 2024.  This is applicable to home and community-based service agencies. The update outlines information required for the administrator and alternate administrator.  This provider letter replaces PL 2021-37.

Medicare Program Integrity Manual – Chapter 10 Updated

Program: Hospice

2023 was a busy year for hospice providers with regards to regulatory changes.  CMS last updated chapter 10 of the Medicare Program Integrity Manual December 7, 2023.  This update included the qualifications for Marriage and Family Therapists and Mental Health Counselors, as well as included the updated 36-month rule, now applicable to hospice providers as well as home health providers.  Check to ensure you have the most current version of the manual.

Hospice Item Set Manual Updated

Program: Hospice

CMS recently made minor updates to the HIS manual.  The most current version of the manual, V3.01, is available for download.  CMS also has a change table available for providers outlining these changes.

CMS Hospice Comprehensive Assessment Quality Measure Fact Sheet

Program: Hospice

CMS updated the Hospice Comprehensive Assessment Quality Measure Background and Methodology Fact Sheet during January 2024.  This fact sheet helps providers understand the key care measures that are captured in this measure and how the measure is calculated.

Hospice Provider Enrollment Reminder

Program: Hospice

CMS has issued a revised version of MLM Matters number MM13333.  In this revision, CMS notes all Medicare providers and suppliers must report all current managing employees, including the medical director and administrator.  Hospices who may not have previously reported this information must do so now.

California Senate Bill (SB) 302 – Compassionate Access to Medical Cannabis Act

Program: Acute Care Hospital, Home Health, Hospice

​Patients Over 65 With a Chronic Disease

Effective January 1, 2023, a patient over the age of 65 who has received a physician’s assessment declaring that they have a serious medical condition, as defined by Health and Safety Code (HSC) section 11362.7 (h), and that the use of medicinal cannabis is appropriate must be allowed use of medicinal cannabis by a SNF, CLHF, SH, HOFA, or HHA. Patients over 65 with a chronic disease and a physician’s recommendation for medicinal cannabis use must provide the health care facility a copy of their medical marijuana card or written documentation of the physician’s assessment and recommendation.

GACH patients over 65 with a chronic disease are excluded from the bill’s medicinal cannabis authorization; however, terminally ill GACH patients may continue to use medicinal cannabis. No patient receiving emergency services and care may use medicinal cannabis.

Inclusion of HHA Patients

SB 302 adds HHAs to the Act’s definition of health care facilities; therefore, they must allow both terminally ill patients and those over 65 with a chronic disease to use medicinal cannabis. This bill exempts HHA patients from the prohibition against smoking or vaping medicinal cannabis but requires each HHA to prohibit cannabis smoking or vaping immediately before or while HHA staff are present in the patient’s residence.

The bill also exempts HHAs from the following Act requirements:

• Secure storage of the medicinal cannabis. 
• Development and dissemination of written guidelines for the use and disposal of medicinal cannabis.
• Removal and disposal of remaining medicinal cannabis by the health care facility after a patient’s discharge.

Hospice: New Requirement for Physicians Who Certify Patient Eligibility

Program: Hospice

Effective May 1, 2024, for Medicare to pay for hospice services, the following physicians must enroll in Medicare or opt out:

1. Hospice medical director or the physician member of the hospice interdisciplinary group who certifies the patient’s terminal condition
2. Patient-designated attending physician (if they have one) who certifies their terminal condition

If you’re currently enrolled or opted out, you don’t need to do anything.

This new requirement:

• Only applies to Fee-for-Service Medicare
• Doesn’t prohibit the patient’s independent attending physician from treating them while in hospice and billing for these services under Part B
• Applies to all written or oral certifications under § 418.22(c)

Hospices can quickly verify a physician’s enrollment or opt-out status using the CMS ordering and referring data file (ORDF), which lists all Medicare-enrolled and opted-out physicians. We’ll modify the ORDF to create a separate column with this status.

Provider and Supplier Compliance Education Through Quality in Focus

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Home Health, Hospice, Renal Dialysis

Quality in Focus: CMS developed a series of short (10–15 minutes), Quality in Focus interactive videos tailored for specific provider types. The series aims to increase the quality of care for people with Medicare and Medicaid by reducing the deficiencies most commonly cited during the CMS survey process, such as infection control and accident prevention.

Hospice – Revisions to Hospice Appendix M of the State Operations Manual

Program: Hospice

Revisions to Appendix M and complementary revisions to the CMS Hospice Basic Surveyor Training will equip surveyors from all surveying entities (State Agencies and Accrediting Organizations) to focus on the quality of care and facilitate consistency. • Surveyors who have previously taken the CMS Hospice Basic Surveyor Training will take an abbreviated training that explains the new approach, while all surveyors (State Agencies and Accrediting Organizations) who have not taken an earlier version of the CMS Hospice Basic Surveyor Training will take the full revised training.

New Waived Tests for Home Health and Hospice

Program: Home Health, Hospice

Listed below are the latest tests approved by the Food and Drug Administration (FDA) as waived tests under CLIA (Clinical Laboratory Improvement Amendments of 1988).

The CPT code, effective date and description for the latest tests approved by the FDA as waived tests under CLIA are as follows:

• 82010QW, 82962, May 27, 2022, AmVentureX Inc. BioCoach Blood Glucose and Ketone Monitoring System;
• 80305QW, June 07, 2022, Micro Distributing STATDIP One Step Drug Test;
• 80305QW, June 07, 2022, Micro Distributing STATCup II One Step Drug Test Cup;
• 87880QW, June 09, 2022, Clarity Diagnostics LLC Clarity Strep A Rapid Test Strip;

Home Health & Hospice: Medicare Provider Resources

Program: Home Health, Hospice

November is Home Care & Hospice Month, is a great time to get familiar with these resources:

• Medicare Payment System educational tool.
• Hospital-based Hospice Medicare provider compliance tips.
• Creating an Effective Hospice Plan of Care fact sheet.
• Enhancing RN Supervision of Hospice Aides Services fact sheet.
• Safeguards for Medicare Patients in Hospice Care fact sheet.

Hospice – Free Medicare Hospice YouTube Video

Program: Hospice

National Government Services (NGS) has an array of educational Medicare Hospice YouTube videos regarding billing and documentation. These videos are free, short in length and very informative. They contain information on the required elements of the hospice notice of election statement (NOE) and how to correct a date on the hospice NOE. Please share these links with your clinical and billing staff as appropriate:

Texas – Licensing Requirements for In-home Supportive Palliative Care

Program: Home Health, Hospice, Private Duty

The legislation created Texas Health and Safety Code (HSC) Chapter 142A (relating to Supportive Palliative Care), establishing a definition of “supportive palliative care” and indicating that any reference to “palliative care” in law or the Texas Administrative Code (TAC) means supportive palliative care. The statute did not establish a category of licensure for the provision of supportive palliative care services—either standalone or as a category within an existing care delivery setting. Supportive palliative care services that are delivered in the home or in community settings, such as in assisted living facilities, are currently governed by HSC Chapter 142 (relating to Home and Community Support Services Agencies (HCSSA)). An HCSSA license is required.

No Surprises Act: Fact Sheets for Your Patients

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Home Health, Home Infusion Therapy, Hospice, Renal Dialysis

Share information with your patients to help protect them from surprise billing. As of January 1, 2022, they have new billing protections when they get:

• Emergency care
• Non-emergency care from out-of-network providers at in-network facilities
• Air ambulance services from out-of-network providers

2025 update to Complying with Medicare Signature Requirements

Program: Clinical Laboratory, Durable Medical Equipment and Supplies, Home Health, Home Infusion Therapy, Hospice, Orthotics, Prosthetics, Renal Dialysis

Signature Requirements
The ordering or prescribing physician or Non-Physician Practitioner (NPP) must make a mark or sign on a document indicating their knowledge, approval, acceptance, or obligation to services
provided or certified. This article reviews what type of signature is acceptable. For example: Electronic, handwritten, signature logs and more.

What’s Changed?
We added information about:
● Stamped signatures (page 2)
● Artificial intelligence (page 2)
● Attestations and signature logs (page 3)
Substantive content changes are in dark red.

Hospice Inpatient Unit – Specialized Prescription Drug Outlet

Program: Hospice, Pharmacy

(b) A pharmacy located in a hospice inpatient unit may register as a specialized prescription drug outlet if the pharmacy compounds drugs and devices and dispenses and delivers the drugs and devices, or provides pharmacist care services, to residents of the hospice inpatient unit.

Home Health & Hospice: Medicare Provider Resources

Program: Home Health, Hospice

Medicare covers a wide range of home health and hospice services. November, Home Care & Hospice Month, is a great time to get familiar with these resources:

Illinois – Update to the Nurse Practice Act

Program: Home Health, Home Infusion Therapy, Hospice, Private Duty, Renal Dialysis

Sets forth rules to modernize the Nurse Practice Act.

IL 18308 2020

Maryland – Residential Service Agency training requirements

Program: Home Health, Home Infusion Therapy, Hospice, Private Duty

FOR the purpose of requiring each residential service agency, beginning on a certain date, to ensure that certain individuals receive certain training relating to dementia; providing that certain training may be provided by a certain supervisory staff member; prohibiting a residential service agency from requiring certain individuals to complete certain training; requiring an individual who provides certain training to issue a certification of completion to each individual who completes the training; requiring each residential service agency to maintain certain records; requiring certain individuals who have not received certain training to complete certain training on or before a certain date; defining a certain term; providing for the application of this Act; and generally relating to residential service agencies.

California Moratorium on new Hospice licenses.

Program: Hospice

Adopted bill regarding Hospice licensure moratorium on new licenses. The California Hospice Licensure Act of 1990 requires a person, political subdivision of the state, or other governmental agency to obtain a license from the State Department of Public Health to provide hospice services to an individual who is experiencing the last phase of life due to a terminal disease, as defined, and their family, except as provided.

CA S 664

Colorado – proposed rule Hospices providers residential care

Program: Hospice

CO S 214

Workplace Violence Prevention for Health Care and Social Service Workers Act

Program: Assisted Living, Home Health, Home Infusion Therapy, Hospice, Private Duty, Renal Dialysis, Sleep

Directs the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan.

US H 1195

CMS Hospice memorandum – Nursing shortage as an “extraordinary circumstance”

Program: Hospice

Extraordinary Circumstances as Related to Hospice Staffing Requirements: A hospice may use contracted staff, if necessary, to supplement hospice employees in order to meet the needs of patients under extraordinary or other non-routine circumstances. The regulation allows the hospice to utilize these services temporarily without a waiver or exemption from the State Survey Agency (SA) or the CMS Location.

Manual Updates Related to the Hospice Election Statement and the Implementation of the Election Statement Addendum

Program: Hospice

The Centers for Medicare & Medicaid Services (CMS) is making changes to the Medicare Benefit Policy Manual to include the modifications to the election statement and the requirements for the hospice election statement addendum, effective for hospice elections beginning on or after October 1, 2020.

SAFEGUARDS FOR MEDICARE PATIENTS IN HOSPICE CARE

Program: Hospice

Hospice is an increasingly important benefit for the Medicare population. The goals of hospice care are to make terminally ill patients, with a life expectancy of 6 months or less, be as physically and emotionally comfortable as possible and to support their families and other caregivers throughout the process. Medicare patients who elect hospice care are an especially vulnerable population. They have the right to be free from abuse, neglect, mistreatment, and misappropriation of patient property. When hospices cause harm or fail to prevent or mitigate harm caused by others, patients are deprived of these basic rights.

Florida – Human Trafficking Sign posting requirements

Program: Home Health, Hospice, Pharmacy, Private Duty, Sleep

Each health care practitioner licensed by one of the named Boards in section 456.0341, Florida Statutes, must post a sign regarding human trafficking in a conspicuous place accessible to employees by January 1, 2021. The sign must be at least 11 X 15 inches and in at least 32-point type. The sign must contain statutorily required language and be posted in English and Spanish. The Department of Health has also provided Mandarin and Creole translations of these signs for use in offices where those languages are spoken.

This effects Occupational Therapist, Physical Therapist, Respiratory Therapist, Registered Dietitian, Pharmacist.

The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, has been updated

Program: Durable Medical Equipment and Supplies, Home Health, Hospice, Orthotics, Pharmacy, Prosthetics, Sleep

The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal.  The use of the renewed form with the expiration date of 06/30/2023 will be mandatory on 8/31/2020.

Update – Due to COVID-19 concerns, CMS is going to expand the deadline for use of the renewed ABN, Form CMS-R-131 (exp. 6/30/2023).  At this time, the renewed ABN will be mandatory for use on 1/1/2021.  The renewed form may be implemented prior to the mandatory deadline.

Texting of Patient Information among Healthcare Providers -Release of S&C Memo 18-10-ALL, updated 1/5/2018

Program: Ambulatory Care, Behavioral Health, Durable Medical Equipment and Supplies, Home Health, Hospice, Orthotics, Pharmacy, Prosthetics

Memorandum Summary:

• Texting patient information among members of the healthcare team is permissible if accomplished through a secure platform
• Texting of patient orders is prohibited regardless of the platform utilized
• Computerized Provider Order Entry (CPOE) is the preferred method of order entry by a provider

NPI: What you need to know booklet

Program: Behavioral Health, Durable Medical Equipment and Supplies, Home Health, Hospice, Orthotics, Pharmacy, Private Duty, Prosthetics

National Provider Identifier (NPI) – Educational booklet on what you need to know about the NPI.

Hospice Documentation Tips

Program: Hospice

Summary: Medicare coverage of hospice depends on a physician’s certification that an individual’s prognosis is a life expectancy of six months or less if the terminal illness runs its normal course. Since determination of decline presumes assessment of the patient’s status over time, it is essential that both baseline and follow-up determinations be reported where appropriate. Patients that have ceased to show on-going decline or who have plateaued from a trajectory of decline may no longer meet hospice eligibility guidelines despite a significant need for custodial care.