Medicare Compliance & Reimbursement

Healthcare providers fighting to serve Medicare patients in flooded areas are receiving some much-needed regulatory relief from Washington. Department of Health and Human Services Secretary Mike Leavitt has designated Iowa and Indiana flood areas as public emergencies. "The flooding in Iowa and Indiana is devastating to each individual and to their communities," Leavitt says in a June 16 press release. "This designation will allow HHS to immediately assist our beneficiaries and providers in the areas where hospitals and other healthcare delivery systems have been disrupted." For evacuated beneficiaries, "the normal burden of documentation will be waived and ... they can act under a presumption of eligibility," HHS says. The release says that CMS will waive certain program requirements for four types of institutional providers: • Critical access hospitals: Allow these hospitals to take more than the statutorily mandated limit of 25 patients and not count the expected longer lengths of stay for evacuated patients against the 96-hour average; • Skilled nursing facilities: Waive the three-day prior hospitalization requirement for admission for evacuated patients and relax limitations on the benefit period for those evacuated patients; • Long-term care hospitals: Not count the evacuated patients in calculating the 25-day average length of stay; and • Inpatient rehabilitation facilities: Not count the evacuated patients in determining compliance with the 60 percent rule requirement. The 60 percent rule says at least 60 percent of the population in a facility must be deemed eligible for that facility. "In emergencies such as this, CMS has the flexibility to ensure that vital healthcare services can be maintained and utilized," says Centers for Medicare & Medicaid Services Acting Administrator Kerry Weems. "Many of the agency's normal operating procedures will be relaxed to speed provision of healthcare services to the elderly and persons with disabilities who depend upon these services." More information is at http://www.cms.hhs.gov/emergency/20_midwestflooding.asp.