Provider Enrollment Contractor Issue Collection

Source: AAHomecare

The DMEPOS industry currently operates with five contractors overseeing provider enrollment matters:

• Two provider enrollment contractors:
• • Novitas for the eastern region
  • Palmetto GBA for the western region
• Two site visit contractors:
• • Deloitte for the western region
  • Palmetto GBA for the eastern region
• Additionally, a new contractor, C-HIT, handles appeals and rebuttals.
  

These recent changes and additions have introduced challenges for suppliers, including application and revalidation backlogs, as well as concerns with the training of new staff at the contractors.

It is imperative for suppliers to keep their Medicare enrollment applications (Form 855S) up to date. The inclusion of C-HIT as the appeals and rebuttals contractor has added complexity to the enrollment process, making it more challenging for suppliers to navigate.

To document and assess the challenges faced by suppliers, the Advisory Council for Enrollment has developed two web-based forms for suppliers to report issues they encounter. Suppliers experiencing difficulties with the provider enrollment contractors are strongly encouraged to utilize these forms for tracking and trending purposes. You can access the forms through the provided links to submit your concerns as needed.

• Form for Site Inspection Issues: SITE INSPECTION TRACKING FORM 
• Form Appeals and Rebuttals Issues: APPEALS & REBUTTALS TRACKING FORM

How to Respond to Audits

A 90-Minute Lunch & Learn Audio Conference by Elizabeth E. Hogue, Esq.

Date: April 25 at 1:00 p.m. to 2:30 p.m. ET

Home health, hospice, private duty, and HME providers are routinely subject to audits of all kinds; including by MACs, SMRCs, RACs, and UPICS. The purpose of this teleconference is to help providers respond successfully to all types of audits. What is the first step providers should take to respond to audits? What should providers do if they find deficiencies in documentation? Can providers supplement and/or amend records before submission? If so, how should providers do so? What about summaries of records? Are they useful and, if so, how? What should be included in summaries? Providers continue to take a beating from auditors, so now is the time to understand the best way to beat them. There will be plenty of time for questions during the teleconference and extensive handouts will be provided.

Replay: May 2, 2024 (Recorded playback available for 24 hours)

Register: https://athomes.org/sys/website/system-pages/?pageId=1852790

Webinar: May 23 at 2 pm ET

In this presentation, representatives from the provider enrollment advisory council will delve into the recent changes to Medicare provider enrollment requirements that went into effect January 2024. With a focus on protecting your Provider Transaction Access Number (PTAN). Let’s explore the key points:

• Expanded Authority: CMS has expanded its authority to revoke or deny enrollment in the Medicare program. One mistake could cost 12 months of cash flow disruption.
• Risk Mitigation Strategies: Learn how to mitigate risks associated with provider enrollment to remain proactive in abiding by the supplier standards.
• PTAN Protection: Understand the critical role of your PTAN and how to safeguard it.

Presenters: 

• Kelly Grahovac, General Manager, The van Halem Group,
• Lisa Wells, VP of Corporate Compliance, Med-South, Inc & Affiliates

Panelists:

• Noel Neil, VP of Auditing and Corporate Compliance, ACU-Serve Corp.
• Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, VGM & Associates

Register: https://register.gotowebinar.com/register/9058955904441207387?source=Sales

Restrictive Covenants

A 90-Minute Lunch & Learn Audio Conference by Elizabeth E. Hogue, Esq.

Date: May 23 at 1:00 p.m. to 2:30 p.m. ET

Restrictive covenants take many forms; including non-competes, non-solicitation, and non-disparagement agreements. Home health agencies, hospices, private duty agencies, and HME companies have all used restrictive covenants. Marketing and key staff members have often entered into non-compete agreements with their employers. Non-competes, however, are currently under tremendous fire. What can employers do? How should non-compete clauses be structured so that they are likely to pass muster with regulators? What about geographic limits? What about the length of time that non-competes are in effect? Employers may also be concerned about solicitation of both patients and other employees. How can they protect themselves from potentially serious losses? What about the use of non-disparagement agreements to help ensure that former employees don’t “bad-mouth” employers to patients, employees, and others in the community? There will be plenty of time for questions during this teleconference and extensive handouts will be provided.

Replay: May 30, 2024 (Recorded playback available for 24 hours

Register: https://athomes.org/sys/website/system-pages/?pageId=1852790