NAHC calls on HCFA to rescind new program memorandum
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON The National Association for Home Care (NAHC; Washington) formalized its strong objection to the Health Care Financing Administration’s (HCFA; Baltimore) new program memorandum (PM) on beneficiary notices Aug. 18 by demanding that the agency rescind the new requirement immediately. Instead, NAHC said HCFA should hold a joint meeting of providers and beneficiaries to develop "appropriate and workable" beneficiary notices, as well as new implementing instructions and schedules.
HCFA’s PM includes three new Home Health Advance Beneficiary Notices that home health agencies will have to begin using no later than Sept. 30 when providing services to Medicare beneficiaries. It requires home health agencies to provide written notice to beneficiaries before providing any non-covered services or reducing or terminating care unless a physician has initiated those changes.
"At no time did HCFA provide the opportunity for involvement of the home health industry in the content of the notice, the manner of communication of the revised instruction to home health agencies, or the timing for implementation of the instructions," NAHC’s Bill Dombi wrote HCFA Deputy Administrator Mike Hash. In addition to the operational problems posed by the new requirement, Dombi cited "serious legal defects" in the process HCFA used to issue the memorandum.
For example, he argued that it cannot be determined from the PM whether home health agencies must be in compliance effective Sept. 30 or whether the intermediaries must provide instructions to agencies by that date. But he said it is "inconceivable" that agencies can make the necessary changes within that time frame.
Dombi also pointed out that there is no congressional requirement for HCFA to mandate these changes by Sept. 30. "It is simply not prudent to hastily pursue this effort," Dombi argued. "Hurried communications result in poor communications."
The new PM also violates the Administrative Procedures Act, the Paperwork Reduction Act and Medicare law, according to Dombi. Worse yet, it also flies in the face of HCFA’s recent overtures to open lines of communication with the home health industry. "We were greatly encouraged by HCFA’s efforts in scheduling a Town Meeting in Washington, D.C., where numerous HCFA officials had the opportunity to hear from and interact with the home health care community," he said. "We can only hope that the issuance of this Transmittal without the opportunity for adequate involvement of the home health community and beneficiary representatives is an anomaly."
A HCFA spokesman said last week that no changes in the PM are imminent but some industry veterans think HCFA is likely to delay the requirement prior to its implementation date now that yet another firestorm has developed.
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