Medicare Compliance & Reimbursement

Delivering the notice at the start of care is OK.

The expedited review notice may be a crushing new burden on home health agencies, but there are a few bright spots in new information on the requirement.

Good news: The Centers for Medicare and Medicaid Services appears to be treading lightly in the enforcement area for the rule, which took effect July 1.

"CMS is well aware this review process is new to both beneficiaries and providers, and not much advance notice could be given to either because of the regulatory processes for finalizing both the regulation and notices," the agency says in its June 3 transmittal to intermediaries.

Bottom line: "CMS will not seek to take punitive action in such cases as all involved parties become accustomed to the process," it says in the transmittal.

Of course, when that trial period ends is unclear, so smart providers will get their compliance ducks in a row as fast as they can.
 
HHAs Need To Prepare Documentation, Not Panic

HHAs shouldn't get "worked up" over the new requirement if they can't get all the details nailed down immediately, advises Burtonsville, MD-based attorney Elizabeth Hogue. As long as a provider thoroughly documents a good faith effort to comply with the requirement, Hogue believes it will be in the clear.
 
Providers Should Heed New Issuance Guidelines

Possibly the most transforming clarification is that agencies can issue the expedited review notices any time up to the second-to-last visit - including at the start of care.

Nothing in the regulation precludes agencies from issuing the generic and detailed notices at the outset of care, CMS admitted in the June 20 special Open Door Forum on the topic.

Furnishing the generic notice up-front may be a practical strategy HHAs want to adopt, suggests Gene Tischer with Associated Home Health Industries of Florida.

"You can just make it part of your sign-up packet" provided you can predict the discharge date accurately, according to Tischer.

Even if the discharge date changes, a provider can issue an amended notice when the change occurs instead of waiting until the last moment, Hogue points out.