Home Health & Hospice Week

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 checks and fingerprinting.

One change: The OIG "decided not to consider all publicly-traded companies to be in the 'limited risk' category," noted law firm Reed Smith on its website.

The regulation also requires a $500 enrollment/revalidation fee. "Medicare application fees are expected to total $304 million over the next five years," Reed Smith notes.

Other provisions: The regulation also finalized the feds' authority to impose payment suspensions and temporary moratoria (see Eli's HCW, Vol. XIX, No. 36, p. 282).