HCFA pressed by OMB on new advance notice requirement
September 27, 1999 2 minutes read
HCFA pressed by OMB on new advance notice requirement
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON The Health Care Financing Administration (HCFA; Baltimore) may be forced to rethink its recent program memorandum requiring home health agencies to begin using standardized advance beneficiary notices as of Sept. 30. HCFA officials are supposed to meet with representatives from the National Association for Home Care (NAHC; Washington) and officials from the Office of Management and Budget (OMB; Washington) later today in an attempt to sort out the controversy that erupted after HCFA issued the new requirement Aug. 18.
On Sept 10, NAHC urged HCFA Deputy Administrator Mike Hash to postpone the new mandate and consult with industry representatives about the new mandate. "We are really not looking to to redo the notice," said NAHC’s Bill Dombi, "but we want it done right, and we want it done right the first time."
Last week, HCFA tried to end-run NAHC’s appeal and insulate itself against charges that it violated the Paperwork Reduction Act and other mandates by requesting emergency clearance of the new requirement from the OMB. The emergency request, published in the Federal Register Sept. 22, gives home health agencies only a week to comment.
A HCFA spokesman said that agencies should be prepared to comply with the new requirement by Sept. 30, as calls the emergency clearance request routine. But Dombi said that while the outcome of today’s meeting is uncertain, it was NAHC’s action earlier this month that prompted the quick-run emergency clearance approach. "HCFA had no intention to go for paperwork reduction act clearance," he said. "We may end up with the same outcome, but HCFA is going to have to justify their position a little better to OMB."
Several possible outcomes could result from HCFA’s last minute request and today’s meeting. If the OMB does not answer HCFA’s request by Sept. 30, as requested by the agency, the notice will not have OMB clearance, and the agency will lack authority to sanction agencies that do not comply with the new rule, according to Dombi. "They could have a paper tiger out there because if somebody ignores it, there will be no consequence," he said.
The OMB could also reject emergency clearance and force the agency to go through the regular clearance process. Finally, the OMB could approve the emergency request, but make it effective as many as 120 days later.
But Dombi notes that the OMB will have to grapple with the possibility that if they reject HCFA’s emergency clearance request, it could impact a pending lawsuit in Hartford, CT, where roughly a dozen Medicare beneficiaries contend their home health services were terminated without proper notice. The new advance beneficiary notice requirement is part of HCFA’s strategy to preempt that case, according to Dombi.
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