CMS may still add your state. Are you ready to conduct exhaustive background checks on all your direct care employees?
A pilot program requiring home health agencies in six states to conduct federal and state background checks is set to begin, and it could spread nationwide.
The project, which was mandated in the Medicare Modernization Act of 2003, will compel a number of types of facilities to conduct the checks, including HHAs and personal care agencies, a Centers for Medicare & Medicaid Services official explained in the Jan. 25 Open Door Forum for home care providers.
The pilot states - Alaska, Idaho, Michigan, Nevada, New Mexico and Wisconsin - also have discretion to include other types of providers. Many states have chosen hospices, the CMS staffer noted.
CMS still may add another state to the list for the three-year pilot. MMA provided for up to 10 states to participate.
In addition to checking direct care candidates' 10-fingerprint record against FBI and state databases, providers must check them against any available state registry as well, the official clarified.
It will be up to the state to determine exactly what offenses and crimes disqualify a person from holding a direct care job, although MMA gives some broad outlines of disqualifying actions, CMS said.
Agencies are concerned about having to wait up to six months for background checks to clear before hiring clinicians, Bob Wardwell with the Visiting Nurse Associations of America noted in the forum. The project allows for a supervised, provisional employment period for candidates, but the nature of home care doesn't allow for such supervision, protested Wardwell, a former CMS official.
CMS is convinced that under the new technologies available in the pilot, providers will be able to obtain background check results in a matter of days rather than months, the official maintained. More information on the pilot is at
www.cms.hhs.gov/medicaid/survey-cert/bcp.asp.
Other issues raised in the forum include:
Contractor satisfaction survey. A contractor sent out 8,200 contractor satisfaction surveys to providers in mid-January, CMS said. Providers can rate their intermediaries or carriers on seven administrative functions (see Eli's HCW, Vol. XIII, No. 45, p. 360).
If you didn't receive a survey, you are out of luck. Providers can't request surveys because doing so would mess up the random sampling required, a CMS official explained.
CMS expects to finalize and disseminate a report on the survey results by summer. More information is at
www.cms.hhs.gov/providers/mcpss/default.asp or survey recipients can call 1-888-863-3561.
Medical review changes. Changes to medical review soon will be coming down the pike. CMS will include in its Program Integrity Manual more specific requirements for sampling provider claims, a CMS staffer explained in the forum. The new instructions, included in an upcoming transmittal (Change Request 3703), will specify [...]
