Home Health & Hospice Week

Especially now, the devil is in the demonstration details.

The feds' new demonstration project targeting fraud among home health agencies should be a wake-up call for all providers that have been slow to embrace new Medicare rules for enrollment and re-enrollment, experts say.

The demonstration, set to commence immediately in the greater Houston and Los Angeles areas, requires among other things, that all agencies submit new enrollment applications to continue participating as a qualified Medicare HHA.

In May, the Centers for Medicare & Medicaid Services revamped its Medicare enrollment process for HHAs and hospices, as well as for suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) and other health care providers.

Bad timing: That means the fraud crackdown and new emphasis on enrollment and re-enrollment comes at a time when providers aren't very familiar with new versions of CMS form 855.

"The enrollment form is complex and difficult to complete," warns Elizabeth Hogue, an attorney in Burtonsville, MD.

Rule number one: When you are required to file form 855A, you must file it correctly--the first time. Insiders say that fiscal intermediaries may not be forgiving if home health agencies make mistakes on their enrollment applications.

"Some of our clients have been told that if errors are made, the form will not be returned to them by the intermediaries: The agencies will just be disenrolled," says Hogue.

Resource: For advice from CMS on completing form 855, go online to www.cms.hhs.gov/MedicareProviderSupEnroll.