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March 04, 2016

Proposed Regulation Offers Documentation Relief to Home Care Agencies

The New York State Department of Health has posted for public comment a proposed rule that would extend from 30 days to one year the time for home care agencies to submit documentation required for reimbursement of physician-ordered services.

Under current New York regulation, certified home health agencies (“CHHAs”) and licensed home care service agencies (“LHCSAs”) have 30 days to obtain an authorized practitioner signature for all medical orders and nursing diagnoses after admission or any change to the order. The proposed rule would amend Section 763.7(a)(3) (for CHHAs) and Section 766.4(d) (for LHCSAs) of Title 10 of the New York Codes, Rules and Regulations to give the agencies 12 months to obtain the signed practitioner order “or prior to billing, whichever is sooner.” That timeframe aligns with the one-year period for submitting claims for Medicare payments under CMS regulations.

The new rule was proposed as a result of recommendations made by the Home and Community Based Care Workgroup, which was established by New York State budget legislation to examine critical areas of home care regulation. The proposed rule is open for public comment through March 26, 2016.

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