Medicare Prior Authorization Proposed for Home Health Services
February 9, 2016 08:58 AM
The Centers for Medicare & Medicaid Services has proposed a demonstration program on Medicare home health prior authorization in Florida, Texas, Illinois, Michigan, and Massachusetts. The announcement was buried in a Paperwork Reduction Act notice in the Federal Register (available here).</p>
The states involved are all under the HHS/DOJ fraud enforcement program known as H.E.A.T. except for Massachusetts. The National Association for Home Care & Hospice (NAHC) expects to oppose it as the antifraud enforcement efforts are already well targeted. As such, a prior authorization program will raise administrative costs with little or no return.
The proposal is open for public comment until April 5, 2016. We encourage everyone, including those outside of the targeted states, to consider submitting comments. NAHC will make its draft comments available for your review in the near future.