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Home Health & Hospice Week

Regulations:

New England Providers' M0175 Reprieve A Short One

Published on Thu Nov 13, 2003

Home health agencies served by Associated Hospital Service of Maine will get a break from M0175 pre-pay edits all right - for one short month. The Centers for Medicare & Medicaid Services said in its Oct. 24 instructions to regional home health intermediaries that "The Arkansas Part A Shared System is exempt from making the changes described." Those changes in Trans. No. 13 require RHHIs to implement pre-payment edits and annual post-payment audits recouping funds when agencies fail to mark a hospital stay in M0175. AHS currently operates under the APASS claims processing system, unlike the other three intermediaries, which use the Fiscal Intermediary Shared System. But AHS will switch to FISS in May 2004, a CMS official says, a mere month after the pre-pay edits for the OASIS item will take effect. That gives HHAs served by AHS exactly 30 days to enjoy their exempt status. And AHS will undertake retroactive recoupments the same as the rest of the RHHIs. In fact, its HHAs will be first in line for the takebacks (see "Reimbursement:  M0175...." story).
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