tci Medicare Compliance & Reimbursement - 2016 Issue 9

Home Health Compliance: Flawed Pilot Vexes Home Care Industry

Prior authorization not the only provision in CMS notice that may affect you. Medicare’s proposal for home health prior authorization could have severe repercussions for you. The agency’s Feb. 5 notice in the Federal Register also calls for an extension of data collection for the Centers for Medicare & Medicaid Services’ (CMS’) Medicare Probable Fraud Measurement Pilot. That’s a CMS pilot launched in 2013 that collects “information from home health agencies, the referring physicians and Medicare beneficiaries selected in a national random sample of home health claims” to “establish a baseline estimate of...

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