Industry Notes:
Tougher Enrollment Processes, Payment Suspensions Finalized.
Published on Tue Jan 04, 2011
Get ready for beefed up screening for your Medicare enrollment. The HHS Office of Inspector General published in the Feb. 2 Federal Register a final rule regarding the provider screening provisions in the Affordable Care Act. As proposed last September, the OIG would establish a three-tier category of risk for screening levels -- low, moderate, and high. The provisions most impacting home care providers have stayed essentially the same, according to the final rule that takes effect March 25. Existing home health agencies and durable medical equipment suppliers, plus all hospices, would fall into the moderate risk category. They'll be subject to unscheduled or unannounced site visits on top of the basic requirements, which include verification of Medicare requirements, license verifications, and checks of databases such as the OIG exclusions database. Newly enrolling HHAs and DME suppliers would fall into the high risk category, which will have to undergo criminal background [...]