Home Health & Hospice Week

Fail to reenroll and you won’t be able to bill.

The feds are happy that their new revalidation procedures are whittling the number of Medicare providers. Make sure you aren’t in those ranks by keeping tabs on your revalidation deadline.

In a recent report, the HHS Office of Inspector General praises the Centers for Medicare & Medicaid Services’ “additional efforts to revalidate all existing enrollments [that] yielded substantial revocations and deactivations of existing providers’ billing privileges.” The OIG also notes that “the revalidation process resulted in a much higher percentage of providers being deactivated than revoked,” according to a summary of the report, “Enhanced Enrollment Screening of Medicare Providers: Early Implementation Results.”

Enrollment data is trending in the right direction, the OIG concludes in the report. “After CMS implemented risk screening and site visit enhancements to strengthen the provider enrolment process, we found that providers submitted fewer enrollment applications to CMS in the postimplementation period,” the watchdog agency says.

Plus, “there was … an increase in the rate of applications that CMS returned to providers and a higher rate of approvals (lower rate of denials) among CMS’s enrollment determinations,” the OIG says.

Reminder: Newly enrolling home health agencies are now in the “high risk” category for risk screening, and revalidating HHAs and all hospices are in the “moderate risk” category, the OIG reviews in the report.

CMS kicked off its latest round of revalidations in March (see Eli’s HCW, Vol. XXV, No. 16). If you miss your revalidation window, CMS may deactivate your Medicare billing privileges and make you enroll from scratch.

Make sure you know the ropes with a free educational offering from CMS. The agency has posted a transcript of its March 1 call on revalidation procedures at www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2016-03-01-NPCTranscipt.pdf.

Tip #1: You can look up your revalidation due date in PECOS or in CMS’s new revalidation lookup tool at https://data.cms.gov/revalidation, HHH Medicare Administrative Contractor National Government Services says in a recent message to providers. NGS also sends out revalidation notices in yellow envelopes, the MAC notes. However, other MACs use email only, CMS notes on its revalidation website at www.cms.gov/medicare/providerenrollment-and-certification/medicareprovidersupenroll/revalidations.html.

Tip #2: “Generally, the due date will remain with the provider/supplier throughout subsequent revalidation cycles,” NGS tells providers. “So you will not have to wonder about the due date the next time you need to revalidate.”

Beware: Don’t send in your application early. “Unsolicited applications received six months prior to the revalidation due date will be returned to the provider,” NGS reminds.