Medicare Compliance & Reimbursement

'Dual use' period in effect, official tells forum listeners.

Home health agencies (HHAs) have gotten a reprieve on home health advance beneficiary notices (HHABNs), and it wasn't a moment too soon for most providers.

The Centers for Medicare & Medicaid Services has scratched the June 1 due date for HHABNs, CMS official Elizabeth Carmody announced in the May 24 Open Door Forum for home care providers.

CMS wouldn't give a firm date for the new implementation deadline, but the agency's target right now is Sept. 1, Carmody related. The agency will issue the due date once it is finalized.

Until the not-yet-announced implementation date, HHAs can use either the old HHABN or the new HHABN in a "dual use period," Carmody explained. The delay should lift agencies' sense of urgency, she said.

Providers Cheer Delay

"This is great news!" exclaims Kathleen Anderson with the Ohio Council for Home Care. "The new HHABN is confusing and creates an excessive administrative burden to implement."

Agencies that have been panicking over the new requirement will be relieved, says Karen Hinkle with the Kentucky Home Health Association. The delay gives agencies a chance to test their new processes "without fear of retribution if they goof and fail to issue a HHABN," she adds. "Now they have a bit of breathing space to continue educating staff and troubleshoot and refine their efforts."

HHAs have been uncomfortable with implementing the notice due to widespread confusion about the new requirement, Anderson says. She hopes the delay will help HHAs better prepare for the final due date.

The extension will save some agencies from compliance problems with the ABNs, predicts Joe Hafkenschiel with the California Association for Health Services at Home. "Many agencies are still trying to understand the requirements and would probably not meet the June 1 date," he expects.

The Home Care Association of New York State (HCANYS) hopes CMS will extend the delay even further than its target date, to next Jan. 1, says HCANYS' Mark Kissinger. "We also hope that CMS will reconsider and evaluate all the additional burden placed on home heath agencies," he says.

"And then there is still the hope that this crazy requirement might go away," Hafkenschiel quips.

Of course, a delay announced earlier may have saved agencies a lot of work. "It is a little late," notes Casey Blumenthal with MHA...An Association of Montana Health Care Providers.

And providers shouldn't be so sure extra time will clear up nagging questions, Blumenthal notes. Revised ABN instructions may further cloud the issues or bring up new questions.

What to expect: CMS is using the delay to respond to the high volume of comments received on the HHABN Paperwork Reduction Act notice, Carmody said. The agency has received 150 comments so far under the comment period that ended May 23 and expects to have more comments come in.

CMS will issue a new set of ABN questions and answers in the next few weeks. Then final ABN instructions will come out once CMS addresses the comments and settles outstanding issues, Carmody said.