HOPE Guidance Manual v1.02, § 1.7

HQRP activities operate on a cycle of data collection and submission, compliance determinations, and payment

impact. Referred to as the HQRP FY reporting cycle, the data collected will impact hospice payments two years

later. HOPE data collection consists of selecting responses to standardized items in conjunction with patient

assessment activities and reporting the data to CMS. For example, HOPE data collected, submitted, and

accepted on time during calendar year (CY) 2026 will be processed for compliance determinations in CY 2027.

The impact on hospice payment will occur in FY 2028, which starts on October 1, 2027. See Figure 8 for an

example:

Figure 8: HQRP Compliance and Payment Impact

1.7.1. Compliance Criteria

• The HQRP is currently a “pay-for-reporting” program, meaning that the act of submitting and the

acceptance of the required HOPE data determines compliance with HQRP requirements.

• Timely submission of HOPE data is a factor in determining a hospice’s compliance with the HQRP

requirements and APU determinations.

• To comply with the timeliness requirements providers must submit at least 90% of their HOPE records per

the 30-day submission deadline throughout the calendar year, for each corresponding FY APU period.

• The HQRP includes data submitted by hospices through the HOPE tool, data from Medicare hospice

claims, and an experience of care survey, the Hospice Consumer Assessment of Healthcare Providers

and Systems (CAHPS®) Hospice Survey.

• All Medicare-certified hospice providers must comply with these reporting requirements.

• New providers are required to begin reporting data on the date noted in the letterhead of their CCN

notification letter. However, if the CCN notification letterhead was dated on or after November 1st,

they would not be subject to any financial penalty for f ailure to comply with HQRP requirements for

the corresponding FY.

• Providers who do not comply with reporting requirements for any given reporting period will have their

APU reduced by 4 percentage points for the corresponding FY.

• Specific criteria for determining compliance with HQRP requirements are proposed and finalized

through the federal rulemaking cycle.

1.7.2. HQRP Resources

• Fo

r more information on HQRP requirements, refer to the HQRP Requirements and Best Practices |

CMS webpage and the documents in the Provider Toolkit and the Downloads section.

• To obtain the latest regulations and notices, including proposed and final rules related to the HQRP,

please visit CMS’s Hospice Center web page.

• For more information on CAHPS requirements, refer to CAHPS Hospice Survey.