HCFA to repeal consolidated billing provision included in BBA
By MATTHEW HAY
HHBR Washington Correspondent
BALTIMORE The Health Care Financing Administration (HCFA; Baltimore) is reportedly planning to issue a formal opinion asking Congress to repeal the consolidated billing provision for home health services that was included in the Balanced Budget Act of 1997 (BBA). While no official action has yet been taken, sources tell HHBR there is a growing likelihood that the change is imminent.
"HCFA keeps telling us they are about to come out with a formal opinion on this," one industry representative reported last week. "That would clear the way for HCFA to make that the official position of the agency, but so far they have not been able to say that publicly."
According to the provision, home health services furnished to an individual who is under the plan of care of a home health agency will have to be made to the agency regardless of whether the item or service was furnished by the agency. The provision will go into effect Oct, 1, 2000, unless Congress repeals it. HCFA has the authority to delay implementation of the provision, but it cannot rescind it without congressional authority.
The BBA includes a combination of items the HCFA bureaucracy lobbied for, along with a number of items that were handed to it by Congress. By all accounts, the consolidated billing provision falls in the latter category. Currently, the agency is struggling to implement literally dozens of BBA provisions and Y2K modifications. "HCFA is willing to scrap this one," said the industry representative. DME suppliers argue that the separate reimbursement systems established by Medicare for home health services and DME make the provision unworkable.
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