Medicare Compliance & Reimbursement

Keep a look out for last-minute change.

Home health agencies (HHAs) should prepare for the fact that Connecticut federal court may order a July 1 implementation date for the home health advance beneficiary notice.

Neither side is predicting where the court will fall on the Center for Medicare Advocacy's request for the quicker implementation date.

The government has until June 21 to file its response to the Center's motion. That could mean a very short notice period for HHAs if the court sides with the plaintiffs and orders the July 1 deadline.

The Centers for Medicare & Medicaid Services (CMS) may have a difficult time explaining the many delays in ABN implementation, the National Association for Home Care & Hospice's (NAHC) William Dombi predicts. "The extended time taken by CMS and the last-minute postponement will not help," he says in NAHC's newsletter.

Best case: The home care industry is hoping the Court will err on the side of beneficiaries' best interests and wait for a workable notice to emerge from the regulatory process.

But if that doesn't happen, you can expect "a lot of canceled vacations and a lot of angry people," Dombi tells Eli. HHAs that were nearly fully prepared before CMS called off the June 1 ABN deadline may have an easier time ramping up quickly for a July 1 date, he expects. But those who put off training in hopes of a delay will have a much tougher time getting their policies and procedures in place in mere weeks or even days.

If the government is expecting 100 percent compliance with new ABN rules, "it won't even be close," Dombi warns.

Watch out: Added to the mix is that CMS may go ahead and make some essential changes to the ABN forms, even for a quick July 1 implementation. "They can do it," Dombi believes.

Such changes, especially those on physician order problems, could alleviate beneficiary confusion and make the forms more clear. But they also might require a major re-training of staff on new forms and instructions.