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Avoid Payment Delays: Register for an iQIES Account Now (Action Required)

Dec 16, 2019

This notification serves as a FINAL reminder that you must complete the onboarding process required to gain access to iQIES as soon as possible. Failure to obtain access to iQIES prior to December 23, 2019 could impact your ability to submit assessment data needed for payment purposes beginning January 1, 2020. Claims that cannot be matched to assessments because an organization was not registered in iQIES will be returned to you, preventing Medicare payment. In order to comply with the OASIS 2.31.0 data specifications that go into effect January 1, 2020 Home Health Agencies (HHAs) must be registered in iQIES.

Completing onboarding by December 23, 2019 will allow you time to avoid some common onboarding delays, such as system downtime in preparation for the January 1 release, and possibly the need to utilize the manual proofing process when registering with HARP. In addition, CMS anticipates a surge in iQIES access requests as January 1st approaches, increasing the chances of delays in help desk response times.

If your organization has not yet requested access to iQIES, we recommend that you request access as soon as possible. For instructions on obtaining access, descriptions of roles available to your organization and other important iQIES information, please refer to the onboarding guide link: https://qtso.cms.gov/system/files/qtso/iQIESOnboardingGuide-WebVersion_0.pdf.

Please note that at this time, only certified HHAs will be onboarded to iQIES. For technical assistance, please contact our service desk at: iqies@cms.hhs.gov or by phone: 800-339-9313.

Release Details

Users will have the ability to upload patient assessments in XML format and will have the ability to view their final validation report, in addition to their other reports, directly in iQIES. It is important to note that submission date and time are stored in Coordinated Universal Time or UTC, which is five hours ahead of Eastern Time (ET). The reports will display the UTC time. However, prior to evaluating the submission timeliness of OASIS records for the Home Health QRP, iQIES will convert the UTC time to Eastern Time.

OASIS 2.31.0 Details

iQIES will incorporate the OASIS 2.31.0 data specifications that are effective January 1, 2020. The specification changes include updates to accommodate the new Functional Impairment Level Case-Mix Adjustment under the Patient Driven Groupings Model, or PDGM, as items that were previously inactive for Reason for Assessment 04 and 05 will now be active for assessments with a M0090 Completion Date of January 1, 2020 or greater. These two items are: M1800 Current Grooming, and M1033 Hospital Risk Items History of Falls through None of the Above. Also taken into account is the transition to PDGM for payment calculation; as a result, the Health Insurance Prospective Payment System (HIPPS) Group Code and HIPPS Version Code are no longer required for submission for assessments with a M0090 date of January 1, 2020 or greater. It is important to note that the transition period for accepting the Health Insurance Claim Number (HICN) or Railroad Retirement Board (RRB) number will end on December 31, 2019. After January 1, 2020, only the Medicare Beneficiary Identifier (MBI) will be accepted and providers will no longer be able to submit a HICN on assessment submissions or claims.

For more information on the data specification changes visit: the CMS Home Health Quality Reporting Program (QRP) Data Specifications page: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/DataSpecifications.

Please note that at this time, only certified Home Health Agencies will be onboarded to iQIES. For technical assistance, please contact our service desk at: iqies@cms.hhs.gov or by phone: 800-339-9313.

Last Modified on 2/10/2020