tci Medicare Compliance & Reimbursement - 2005 Issue 30

Home Health: CMS Backs Down On Expedited Review Certification

QIO can't furnish beneficiary risk certification required for review.The number of work-intensive expedited reviews home health agencies encounter may be lower than expected, thanks to a change of heart from the feds. Quality improvement organizations' physicians won't be furnishing beneficiaries with certifications that the lack of continued home care would place the beneficiary's health at significant risk, the Centers for Medicare and Medicaid Services says in a question-and-answer posted this month. That's big news because beneficiaries require such certification to proceed with the expedited review process. Under those reviews, HHAs have to issue a second-step, detailed...

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