Home Health & Hospice Week

One HHH Medicare Administrative Contractor is laying out docs’ referral responsi­bilities, but also may be scaring them out of making referrals at all.

Palmetto GBA walks physicians and referring medical facilities through the documen­tation requirements for patients referred to home health agencies in a recent article on its website titled “Home Health Referrals.” The description ranges from homebound status to intermittent skilled services to face-to-face documentation. HHAs may welcome that reminder, especially with the Patient-Driven Groupings Model with its stepped-up documentation requirements around the corner.

But: The article also contains this bold-face warning to docs: “You are responsible for all claims that you submit or cause to be submitted to the Medicare Program. Medicare assumes that every claim you submit or cause to be submitted is for something that you determined to be medically necessary. Submitting false claims or causing false claims to be submitted can subject you to civil or criminal penalties, and can have consequences on your medical license and ability to bill Medicare. False claims include claims where the service is not supported by the patient’s medical record.”

Observers worry that language may scare off referring physicians who already want to write off home care as too time-intensive on the documen­tation front.