Home Health & Hospice Week

Forgetful providers may see fewer appeals.

Good news: If you have failed to submit documentation in response to a medical review request, you get a second chance.

The Centers for Medicare & Medicaid Services will no longer force you to appeal medical review denials for lack of documentation, according to CMS Transmittal 202 (CR 5246).

Now Medicare contractors will allow you to reopen the claim and adjudicate it through the "progressive corrective action" process, says the transmittal, online at www.cms.hhs.gov/transmittals.

• You have one more patient safety goal to worry about, if you're accredited by the Joint Commission. The JC, formerly known as the Joint Commission on Accreditation for Healthcare Organizations (JCAHO), has set a new National Patient Safety Goal on anticoagulation drugs. The Joint Commission will require providers "to take specific actions to reduce the risks of patient harm associated with the use of anticoagulant therapy," the Oakbrook Terrace, IL-based accrediting body says in a release.

The new goal will have a one-year phase in period in 2008 with full implementation by 2009, the JC says. "The new anticoagulant therapy Requirement addresses a widely-acknowledged patient safety problem and becomes a key element of the Goal: Improve the safety of using medications."

The JC also added a new goal on patient deterioration for hospitals for 2008. More information is at www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals.

• When the Common Working file has an incorrect date of death for a Medicare beneficiary, you're going to have a harder time getting it fixed. The Social Security Administration is the only office that can modify a CWF date of death, regional home health intermediary Palmetto GBA says in a posting on its Web site.

Palmetto now returns all death certificates to providers so they can send them to the SSA to get the CWF date of death corrected, the intermediary explains. "Providers may adjust or resubmit claims, accordingly, after SSA has updated the date of death on the CWF," the RHHI instructs.

• Many states aren't doing their jobs in ensuring providers are meeting Medicare's DME enrollment standards. That's the finding of a 15-state study conducted by HHS Office of Inspector General.

According to the semi-annual report to Congress, most of the states did not routinely verify whether providers are meeting enrollment standards for suppliers of durable medical equipment. The report, which was released in June, notes that fewer than half the states in the study require Medicaid providers to enroll in the Medicare program, which would require them to adhere to Medicare standards.

• A complete list of new and updated ICD-9 codes and descriptors is included in CMS Transmittal 1269 (CR 5643). For more information on diagnosis coding, see Eli's Home Health ICD-9 Alert at www.elihealthcare.com/spec_health_icd-9.htm or by calling 1-800-874-9180.

• Regional chain LHC Group Inc. is continuing its strategy of forming relationships with hospitals. The Lafayette, LA-based company will sell a 33 percent interest of its Lafayette home health agency to Our Lady of Lourdes Regional Medical Center and a 33 percent interest of its Monroe, LA agency to St. Francis Medical Center, LHC says in a release.

LHC will continue to oversee the day-to-day operations of both agencies, it says. The hospitals are both members of Franciscan Missionaries of Our Lady Health System.

• Amedisys Inc. has expanded its presence in another Certificate of Need state. The Baton Rouge, LA-based chain has acquired a Searcy, AR HHA and its Permit of Approval for eight counties in the state, according to a release.

The purchase doubles the number of counties Amedisys can serve in Arkansas, the company notes.