Seeking Feedback on Long-Stay Antipsychotics Measure
LeadingAge is seeking feedback on the impact of the long-stay antipsychotics quality measure on Nursing Home Care Compare. This measure provides information on rates of antipsychotic usage in nursing homes and is utilized in the Five Star Quality Rating System. LeadingAge is a member of Project PAUSE, a coalition advocating for changes to the quality measure due to the relative failure of the measure to distinguish between appropriate and inappropriate antipsychotic usage and we would like your feedback.
- What has been the impact of this quality measure in your nursing home?
- Have your star ratings suffered, and what has been the impact of that?
- Is your nursing home more reluctant to admit potential residents who are already prescribed antipsychotics?
- Have you felt pressured to deprescribe for residents who were appropriately prescribed antipsychotics?
Please share your input by emailing Jodi Eyigor at jeyigor@leadingage.org. Note that we will not share any identifying information – we are simply looking for concrete examples of the impact of this measure.
Congress Responds to Concerns Over Department of Education’s Proposed “Professional Degree” Definition
The Department of Education’s recent interpretation of “professional degree” under H.R.1 excludes nursing programs from the category, subjecting advanced nursing students to lower federal loan limits. This change has raised serious concerns among healthcare advocates and the nursing field, who warn that it could worsen workforce shortages and force students into riskier private loans.
On December 12, more than 140 members of Congress, in a bipartisan letter, urged the Department to include nursing in the professional degree category. Led by Senators Jeff Merkley (D-OR) and Roger Wicker (R-MS) and Representatives Suzanne Bonamici (D-OR) and Jen Kiggans (R-VA), the letter emphasized the high cost of advanced nursing programs and the critical need for these professionals, especially in underserved areas.
Although not specifically related to the nursing field, this week also saw the introduction of two bills related to the issue. Representative Kennedy (D-NY) introduced the Loan Equity for Advanced Professionals Act (H.R. 6574), which aims to establish equal loan limits for graduate and professional students. It proposes the higher limit of $50,000 annually and $200,000 aggregate for both graduate and professional programs, which could indirectly address concerns about nursing programs being disadvantaged under current rules. Also, Representative Ritchie Torres (D-NY) introduced a bill (H.R. 6677) that seeks to reverse the reductions in federal loan availability for graduate and professional students enacted under H.R.1.
CMS Will Reject Long-Term Stay Hospice Claims with the Same “Admission” and “From” Dates
The Centers for Medicare and Medicaid Services (CMS) announced that Medicare Administrative Contractors (MACs) will start rejecting hospice claims that include the same date for both the “admission” and “from” fields in type of bills 813 or 814 and 823 or 824 for long-term hospice care exceeding 270 days. This is an attempt from CMS to combat billing anomalies on interim and final hospice claims which were ending in higher payment rates.
MACs have found that claims submitted with matching “admission” and “from” dates got past system edits. When this happens, the edits for long-term hospice care will not activate because the calculation performed by the Fiscal Intermediary Shared System (FISS) for these edits is based on the difference between the “admission” and “from” dates. The changes will go into effect April 6, 2026. The rejection codes associated with this change will include Claim Adjustment Reason Code 16 – Claim/service lacks information or has submission/billing errors; Remittance Advice Remark Code MA40 – Missing/incomplete/invalid admission date; and Group Code – CO (Contractual Obligation).
Measures Under Consideration (MUC) List 2025 is Out
The Measures Under Consideration (MUC) List for 2025 was released on December 15. This list, released annually by December 1 and delayed this year by the federal government shutdown, details quality measures currently under consideration for the Centers for Medicare & Medicaid Services (CMS) various quality programs.
Among the 24 measures under consideration in 2025, there is one measure under consideration for the Home Health Quality Reporting Program (QRP), Skilled Nursing Facility (SNF) QRP, and SNF Value-Based Purchasing (VBP). This measure, Advance Care Planning, is under consideration for many of the quality programs and varies only slightly by setting. There are currently no measures under consideration for the Hospice QRP. Public listening sessions and public comments will take place in early January 2026. To view the measures and learn more, check out the CMS Measure Management Systems (MMS) Hub.
