Home Health & Hospice Week

Compliance:

ABN Implementation May Lag Behind Termination Notices

Still get ready to tackle the new requirement this summer. The new advance beneficiary notice and termination notice are linked, but they may not hit home health agencies at quite the same time.
 
Termination notices have a statutory deadline from the Benefits Improvement and Protection Act of 2000, but litigation instigated the ABNs. Thus the termination notices are likely to take effect on their July 1 deadline, but ABN implementation may be a bit more delayed, a Centers for Medicare & Medicaid Services official tells Eli.
 
"It would certainly be wonderful to hit the July 1 date," the CMS staffer says. But because interested parties can offer public comment on the ABN through the Office of Management and Budget approval process, CMS doesn't expect to have the final forms and instructions in place by then, the source indicates. However, the agency will be working to get the ABN materials out "as soon as possible," the official says.
 
When the ABN does take effect, it will replace the current ABN form and also replace the proposed notice of exclusions from Medicare benefits (NEMB), the CMS staffer notes. Many of the changes CMS had proposed for the NEMB last June (see Eli's HCW, Vol. XIII, No. 24, p. 186) are incorporated into the revised ABN, including disregarding a physician's orders for services and giving patients the option of continuing services even though there is no physician's order for them.
 
The revised ABN also dropped many of the exceptions included in the NEMB, including not delivering a notice when the patient is found non-homebound or when the care is custodial care.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.