Home Health & Hospice Week

The feds--and state agencies--are watching.

It's not rocket science--but many agencies need a refresher.

That's the consensus about the role compliance plans play in helping home health agencies keep their hard-earned reimbursement.

Compliance plans were a hot topic when the OIG released its guidance on voluntary plans in August 1998. But by now many, if not most, have fallen by the wayside.

"Unfortunately, many compliance plans are a piece of paper, not an active program," observes attorney Robert Markette Jr. with Gilliland Markette & Milligan in Indianapolis.

Here's what you need to do now:

1. Brush up on the basics. It's been eight years since the OIG issued its compliance guidance for home health agencies. If you haven't done so recently, take a fresh look at the document to see how your efforts address key concerns noted in the document. It's available online at http://oig.hhs.gov/authorities/docs/cpghome.pdf.

2. Keep Medicaid compliance on your radar screen. Many states are looking more stringently at Medicaid payments to HHAs, thanks in part to pressure from the feds. Even small technical errors in documentation can lead to payment recoupments.

Don't let this happen to you: An Indiana HHA had to repay thousands in Medicaid funds when an auditor discovered that a home care attendant failed to note her title on official documents, says Markette.

3. Take a new look at cost reports. The Nurses Registry case noted in the HHS Office of Inspector General's Semiannual Report to Congress suggests that agencies' cost reports will come under new scrutiny, says Connie Raffa, an attorney with Arent Fox in New York City. Pay close attention to nonreimburseable versus allowable cost centers as defined in the Medicare Provider Reimbursement Manual, she says.

Trouble spot: You can include costs for public relations, for example, but not advertising, notes Raffa.

Another tip: Audit cost reports to ensure you're not including liaison costs related to hospital discharge planning. In addition to being a nonallowable cost for HHAs, including costs related to hospital discharge planning can set you up for trouble under the anti-kickback statute, warns Raffa.