Survey & Certification:
CHANCES GOOD FOR BIG PUSH TOWARD DEEMING
Published on Mon Oct 15, 2007
Revalidation requests stretch resources.
When Medicare certification is on your to-do list, you may want to go ahead and check in with an accrediting organization.
A look at the recent memo from the Centers for Medicare & Medicaid Services shows that survey and certification resources are indeed stretched thin. Here's a look at the factors conspiring for more deemed status certification:
• Dwindling funds: For the past three consecutive years, the final federal budget for Medicare survey and certification has been considerably less than the level requested by the President, reports CMS.
"Although we remain hopeful that the FY 2008 appropriation will fully fund the President's request, it may be well into the fiscal year before Congress enacts the final FY 2008 budget," cautions the agency.
• Many new providers: Numerous additional providers want to participate in the Medicare program, says CMS. Since 2002, the number of Medicare-certified hospices is up 37.4 percent. The number of HHAs participating in Medicare has grown by 31.9 percent.
For survey agencies, those numbers have translated into a backlog of applications, and for providers, into long waits.
California, for example, has "a significant backlog of agencies awaiting licensure and certification," says Joseph Hafkenschiel, president of the California Association for Health Services at Home in Sacramento.
• More work: CMS cites "additional survey responsibilities," as one reason resources are hard to come by for initial certification. For example, CMS stepped up oversight of hospital transplant programs this year, further stretching survey resources.
• The fight against fraud: On the home health front, officials are in part busy handling an increased load of revalidations, notes Elizabeth Hogue, an attorney in Burtonsville, MD.
Revalidation requests went out in late October to hundreds of home health agencies affected by the Medicare Provider Enrollment Demonstration for Home Health Agencies (see Eli's HCW, Vol. XVI, No. 37). That means an increased workload handling re-certifications.
"Growth in the number of certain provider types, particularly home health, has been accompanied by evidence of higher levels of fraudulent activity by a minority of such providers," noted CMS in the recent survey and certification memo on survey priorities.
