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  NAHC Report: Issue# 2843, 2/12/2016
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CMS Issues Final Rule for Self Reporting Overpayments
Private Duty Conference Highlights: Notes on Doing Business with ACOs
For Your Information: NAHC Announces the March on Washington Conference
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CMS Issues Final Rule for Self Reporting Overpayments

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule for provider and supplier self reporting overpayment requirements.

The rule clarifies requirements for the reporting and returning of self-identified overpayments. Health care providers and suppliers have been and will continue to be subject to potential False Claims Act (FCA) liability, Civil Monetary Penalties Law (CMPL) liability, and exclusion from federal health care programs for failure to report and return an overpayment.

 The major provisions of this final rule include clarifications around: the meaning of overpayment identification; the required look back period for overpayment identification; and the methods available for reporting and returning identified overpayments to CMS.

An overpayment must be reported and returned by the later of: (i) the date which is 60 days after the date on which the overpayment was identified; or (ii) the date any corresponding cost report is due, if applicable. This final rule states that a person has identified an overpayment when the person has or should have, through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment.

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CMS Issues a New Condition Code for Home Health Claims

The National Association for Home Care & Hospice (NAHC) and the Private Duty Homecare Association of America brought two nationally recognized figures – Bob Roth and John Marchica – to Charleston, South Carolina, on February 1-2 to the Private Duty Home Care Conference to explain partnerships with ACOs. Bob Roth is the Managing Director and Co-Founder of One on One Home Care Solutions, and Managing Partner and Co-Founder of Cypress HomeCare Solutions, of Phoenix, Arizona. John Marchica, is the President of Darwin Research Group in Phoenix, AZ.

They provided a wealth of information about ACO partnerships. Mr. Roth utilized his background in trade marketing to emphasize the importance of having a solidly branded agency and the value that brings to a potential ACO. “Private duty home care is the only post-acute provider who can be in the home consistently with the patient after discharge,” he said, and this makes it an asset in the market. Mr. Roth added that consumers who share positive feedback through social media boost the standing of agencies and this, too, can make private duty agencies an attractive partner for ACOs. “Private duty home care needs to share the responsibility of preventing hospital readmissions,” he continued. That is a goal patients, their families, hospitals, and agencies all have in common. “I believe in quality care to produce great outcomes… Quantify the benefit of the partnership and make sure your story can be heard.”

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NAHC Announces the March on Washington Conference
Mayflower Renaissance Hotel, April 4–5, 2016

NAHC is hosting the 2016 March on Washington Conference in the splendid city of Washington, DC. Now is a critical point as we face new rules that could challenge our mission to serve America’s aged, disabled, and ill. Join us as we work to make home care and hospice the center of health care in our country.

The nation’s capital is the heart of legislative activity that affects home care and hospice. That makes it the perfect place to raise awareness of the vital work we do. Together, we can deliver a unified message to those who make the policies that shape our business. Take advantage of this chance to lobby your lawmakers, connect with colleagues, and attend educational sessions led by experts in our field.

Register and Book Your Hotel!

View the Conference Program!


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