Home Health & Hospice Week

Contractor that planned hold in error offers fix.

Home health agencies in 16 states will have to go the extra mile to receive request for anticipated payment (RAP) disbursements from Sept. 22 through Sept. 30.

The National Association for Home Care (NAHC) reported on Aug. 21 that the Centers for Medicare & Medicaid Services has said they will "step in to see that home health agencies [in the region] are not harmed" by the proposed hold.

Background: Although the Deficit Reduction Act of 2005 does mandate a payment hold on Medicare Part A and B claims between Sept. 22 and Sept. 30, a home health RAP is not a "claim" as defined by law, explains NAHC.

Earlier this year, CMS agreed with NAHC that RAPs would not be subject to the hold, the trade group reports. Palmetto GBA, however, announced earlier this summer that the delay would affect RAPs.

Though CMS has confirmed that the RAP hold is in error, the agency says that it's too late to fix the problem, which involves the HIGLAS (Healthcare Integrated General Ledger Accounting System) claims accounting system used by Palmetto.

Home health agencies "who feel they may experience financial difficulties as a result of RAPs being held during the nine day hold period" may request a manual payment. Submit A Special Request To submit a request, fax a written request that includes the following:

• On company letterhead, a statement requesting manual payment for RAPs as a result of the nine day hold period

• Your provider number(s)

• An authorized signature. An authorized signature would be the signature(s) that appears on your 855 form. Or, the request should be signed by the same person who signs your cost reports.

• A physical address. The manual payments will be over-nighted, therefore, an actual physical address is needed.

• A return fax number in order to receive confirmation that your request has been received.

Fax all requests to 803-935-0160.