AGG Hospice CMS Quarterly Report

CMS Announces Hospice Flexibilities to Fight COVID-19

CMS has announced a series of temporary regulatory waivers and new rules to provide hospice providers with
flexibility to respond to the COVID-19 pandemic. The goals of these actions are to expand the healthcare system
workforce; ensure adequate capacity in hospitals and health systems; increase access to telehealth in Medicare;
expand in-place testing; and put patients before paperwork. These exibilities include the following:
Medicare Telehealth and Telecommunications Technology.

Hospice providers can provide services to a Medicare patient through telecommunications technology (e.g.,
remote patient monitoring; telephone calls (audio only and TTY); and two-way audio-video technology), if it is
feasible and appropriate to do so. Only in-person visits are to be recorded on the hospice claim.

Face-to-face encounters for purposes of patient recertification for the Medicare hospice benefits can now be
conducted via telehealth (i.e., 2-way audio-video telecommunications technology that allows for real-time
interaction between the hospice physician/hospice nurse practitioner and the patient).

Training and Assessment of Aides – CMS postponed the annual onsite hospice aide supervisory visit until 60 days
from the end of the public health emergency (PHE).

Annual Training – CMS postponed the annual assessment of hospice aide skills and competence until the end of
the first full quarter following the lifting of the PHE. This waiver does not alter minimum personnel requirements.

Quality Assurance and Performance Improvement (QAPI) – During the PHE, CMS is allowing hospices to narrow
their QAPI focus to infection control issues, along with a focus on any adverse events.

Volunteer Requirement – In anticipation that volunteer availability and use will be reduced due to the COVID-19
pandemic, CMS waived the requirement that hospices use volunteers.

Onsite visits for Hospice Aide Supervision – CMS waived the requirement that a nurse to conduct an onsite visit
every two weeks to evaluate if aides are providing care consistent with the care plan.
Patients Over Paperwork

Comprehensive Assessments – CMS extended the time to complete required patient assessments and updates
from 15 to 21 days.

Waive Non-Core Services – CMS waived the requirement for hospices to provide certain non-core hospice services
during the national emergency (e.g., physical therapy, occupational therapy, and speech/language pathology).

Accelerated/Advance Payments – As of April 26, 2020, CMS is reevaluating all pending and new applications for
the Accelerated Payment Program and has suspended the Advance Payment Program, in light of direct payments
made available through the Department of Health & Human Services’ (HHS) Provider Relief Fund. For providers
and suppliers who have received accelerated or advance payments related to the COVID-19 Public Health
Emergency, CMS will not pursue recovery of these payments until 120 days after the date of payment issuance

Click here to read more!

**This report is is provided to MHPCA through a partnership with Arnall, Golden & Gregory, LLP (Jason Bring-Partner)**

Latest News

Notice to Submit Comments for State of Missouri Hospice Rule

  Anyone may file a statement in support of or in opposition to this proposed amendment with Lisa Coots, Administrator, Bureau of Home Care and Rehabilitative Standards, Department of Health and Senior Services, Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102 or at To be considered, comments must be received within thirty (30) days after publication of this notice in the Missouri Register. No public hearing is scheduled. To read the Missouri Register click here.  

Read More About This Article

Coroner Bill

Governor Signs Coroner Bill Into Law COLUMBIA — On Monday, July 6, 2020 Governor Mike Parson signed HB 2046. Inside the omnibus bill was coroner training reform Jay Minor’s been working toward for years. Minor has been fighting for justice for his son, Jayke, who died in 2011. A 2018 KOMU Target 8 Investigation detailed a flawed autopsy from the Howard County Coroner, who ruled his cause of death to be a drug overdose solely due to Jayke’s history. The new law will update training requirements. Click here to read the full story.

Read More About This Article


COVID-19 Information Update Hospice Staff Curfew Letter (please show if you get stopped by police after hours) Brochure Caring for a sick person at Home – Coronavirus  Link to the National Coalition of Hospice & Palliative Care page You can now view the COVID-19 Provider Billing/Telehealth Presentation on the MO HealthNet training information page. For provider and policy issues regarding MHD Clinical Services Programs, including Pharmacy, The Missouri Rx Plan (MORx), Psychology, Exceptions, and Medical Precertifications, email us at: Questions and comments regarding any other issues should be directed to: The COVID-19 hotline number is 877-435-8411. Missouri Medicaid has offered for MHPCA to answer any questions…

Read More About This Article

Legislative Corner

Hospice Death HB1435 PERFECTED – Rep. Dan Houx – The bill specified that, when a death occurs under the care of a hospice, no investigation shall be required if the death is certified by the treating physician of the deceased or the medical director of the hospice as a natural death due to disease or diagnosed illness. The hospice must give written notice to the coroner or medical examiner within 24 hours of the death (Sections 58.451 and 58.720) VIEW CURRENT STATUS » HB1435 changes the statutes regarding the procedures to follow upon the death of a hospice patient. This…

Read More About This Article
Amazon Smile Logo

Missouri Hospice & Palliative Care Association Incorporated is now a charity on AmazonSmile

What is AmazonSmile?AmazonSmile is a simple and automatic way for you to support your favorite charitable organization every time you shop, at no cost to you. When you shop at, you’ll find the exact same low prices, vast selection and convenient shopping experience as, with the added bonus that Amazon will donate a portion of the purchase price to your favorite charitable organization. You can choose from over one million organizations to support. How do I shop at AmazonSmile?To shop at AmazonSmile simply go to from the web browser on your computer or mobile device. You may also want…

Read More About This Article