The Center for Medicare and Medicaid Services (CMS) was pushing through new requirements for home care providers that will require them to gain approval for any physician or third party government contractor work for clients in order to ensure that Medicaid would pay for the services. While many agencies across the country were concerned about this system and the prospect of providing services that wouldn’t be paid, CMS has delayed implementing the system for at least six months.
The new regulations, according to some home care agency owners and advocates for the elderly and disabled who rely on these services was that any delay could be problematic and leave clients without the services they need.
These advocates had been vocal in their resistance to these new rules and regulations, but there was no indication from CMS that they had any intention to delay or even change these new requirements. Now, though, the brakes have been put on the program for six months.
According to a News Medical Life Sciences release, entitled, Partnership for Quality Home Healthcare Commends CMS for stopping pre-claim review demonstration:
“We are incredibly pleased CMS listened to the concerns expressed by bipartisan lawmakers and home health stakeholders, and suspended the application of the demonstration,” stated Keith Myers, Chairman for the Partnership for Quality Home Healthcare. “While the Partnership fully supports CMS’ intent to reduce waste, fraud and abuse within the Medicare home health benefit, the pre-claim review demonstration is not the right approach and we are grateful CMS has chosen to suspend the program while improvements are made, which we believe will be beneficial to providers, physicians and patients alike.”
This delay, though, may not be permanent, but rather an opportunity to get the program changes in place and ready for all agencies to begin having to submit requests for approval. While the regulations are intended to cut back on fraud and abuse of a system that has long been open to these problems, many of the advocates for elderly and disabled clients say it could cause a lot of these men and women unable to receive the level of care and support they need.
Approximately 3.5 million men and women across the country receive some type of home health care benefit paid for through Medicaid. It is considered the most cost-effective option for those who need some type of care and support or medically-based services at home.