CMS begins enforcing homecare anti-fraud rules

The Centers for Medicare and Medicaid Services is enforcing a rule that home health agencies and hospices must certify that their patients are eligible to receive their services as part of an in-person encounter with a physician, reports AHA News Now.

Part of the Patient Protection and Affordable Care Act, the requirement aims to reduce healthcare fraud, which is commonplace in the home healthcare field. CMS had originally postponed enforcement of the rule from January to April 1 after pressure from constituents to allot more time for provider education.

Nevertheless, various factions in the provider community were displeased that the rule was not delayed even longer. The American Hospital Association had asked for a delay until July, noting in a letter sent to CMS last month that "there is still a great deal of confusion due to the complexity and added administrative paperwork of the new requirements."

Moreover, a recent survey by the National Association for Homecare and Hospice found that nearly 80 percent of respondents expect that referring physicians will not be able to comply with all of the requirements.

For more:
- Read the AHA News Now article
- Read the CMS Notice
- Read the AHA letter

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options. 

Health IT company Cerner announced a definitive agreement to acquire IT consulting and engineering firm AbleVets as a wholly owned subsidiary.