Home Health & Hospice Week

Survey & Certification:

BEWARE DROP-OFF SITES CONSIDERED UNAUTHORIZED BRANCHES

End of stepped-up review in sight for Texas wheelchair suppliers? The termination of a Colorado home health agency's Medicare participation should serve as a warning against letting drop-off sites stray into branch territory. Earlier this year, an administrative law judge upheld the termination of Boulder, CO-based Professional Home Health Care Inc. (see Eli's HCW, Vol. XIII, No. 17). One of the HHA's problems was an unauthorized branch that the agency contended was merely a "paperwork drop box."

The Centers for Medicare & Medicaid Services recognizes only a home health agency, parent, branch or sub-unit, declared a CMS official in the June 23 Open Door Forum. "We do not recognize any other offshoot of an agency," the staffer stressed. If an agency wants to add a location, it should contact the CMS regional office and have it approved as a branch, the CMS official instructed. Other issues raised in the forum include: NPs in hospice. CMS has gotten its regulations on nurse practitioners serving as hospice attending physicians into the manuals, it says. A Medlearn Matters article on the topic is at www.cms.hhs.gov/medlearn/matters/mmarticles/2003/MM3226.pdf and the manual change is at www.cms.hhs.gov/Manuals/pm_trans/R15BP.pdf. Texas wheelchair claims. CMS and durable medical equipment regional carrier Palmetto GBA are contemplating "modifying" the strict medical review imposed on power wheelchair claims from Harris County, TX, a CMS official says. If it feels comfortable reducing the Operation Wheeler Dealer-related review after close monitoring, changes could come in "the not-too-distant future," the staffer pledged.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more