Home Health & Hospice Week

Feds' preliminary 'heads up' to contractors may not be enough.

Hospice providers gained ground last week as they fought for the feds' OK on electronically signed certifications of terminal illness (CTIs). But the battle isn't over just yet.

In a clarification issued Jan. 17, the Centers for Medicare & Medicaid Services nixed the use of electronic signatures in the current period leading up to the agency's release of a revised version of Change Request 5550.

Background: CMS quietly fine-tuned its requirements for signatures on orders and "other medical record documentation for medical review purposes" last summer in CR 5550, a transmittal effective since Sept. 3. The National Association for Home Care & Hospice, the National Hospice & Palliative Care Organization and other stakeholders have since worked with CMS to clarify issues including whether the missive disallowed electronic signatures on CTIs (see Eli's HCW, Vol. XVII, No. 3).

In a Q& A issued by NAHC, CMS responded to this question--"Must [hospices] wait until the revised CR is released to start using electronic signatures?"--with a simple "Yes."

Asked later in the Q&A if the agency planned to instruct the contractors not to deny claims based on signature types of CTIs, CMS answered, "We can give our contractors a 'heads-up.' However, we cannot provide instructions that are not effective yet."