Home Health & Hospice Week

Fail to pay and you could lose Medicare certification.

Speak out now against proposed survey revisit fees: The future of your business could depend on it.

Take a look at four key provisions in the feds' newly proposed rule on survey revisit fees as they affect home health agencies.

1. Complaint surveys. The June 29 rule states that regulators will conduct complaint surveys on the basis of a "substantial allegation of noncompliance," as defined in Section 488.1 of the Social Security Act. Beware the rule's broad take on the word "complaint." A valid complaint could be one submitted in person, by telephone, through written correspondence or through a newspaper or magazine article.

2. Appeals. Agencies can appeal an assessed revisit fee under certain circumstances. "Clerical errors," for example, count as an appeal-qualifying "error of fact."

Catch: But even if you're successful in winning an appeal of a levied user fee, don't expect a fee refund. As the rule stipulates: "If, upon reconsideration, it was found that a revisit fee was assessed due to error of fact, and the provider or supplier has made a payment of the assessed revisit user fee, then CMS shall credit the initial revisit payment against any future assessments of revisit fees."

3. Termination. Pay up, or else. If you're assessed a revisit fee, be prepared to pay or lose your Medicare certification. CMS says in the proposed rule that it plans to "create an additional basis for termination if a provider has failed to pay a revisit user fee when and if assessed."

But that means of enforcement seems to be set already, points out the National Association for Home Care & Hospice. The rule itself states, "If the full revisit user fee payment is not received within 30 calendar days ... CMS may terminate the facility's provider agreement and enrollment in the Medicare program or the supplier's enrollment and participation in the Medicare program."

4. Ways to collect. CMS says in the rule that it will accept a variety of types of payment, including credit cards. But the agency also indicates it can deduct the fees from coming reimbursement, if necessary: "Fees for revisit surveys under this section may be deducted from amounts otherwise payable to the provider or supplier," the rule reads.