Palmetto GBA Likely to Be More Active Soon

Louisiana Home Health Providers,

We’ve talked and written often about the possibility of the fiscal intermediaries getting more active in reviewing claims. In an October 6th letter to HHS Secretary Kathleen Sebelius and CMS Administrator Donald Berwick, U.S. Senator Charles Grassley, Ranking Minority Member of the Senate Finance Committee, is very critical of Palmetto GBA’s performance as a fiscal intermediary. Whether those comments accurately reflect issues in PGBA’s work or not, it would be hard for PGBA not to respond with a more aggressive work plan. There has been an uptick in claims reviews through ADRs (Additional Development Requests) in California by NGS (National Government Services). This fiscal intermediary is also looking into survey and certification issues in Wisconsin. I don’t think it’s a stretch to say we can expect more activity from Palmetto GBA soon.

The week after this first letter, Senator Grassley sent a follow up letter to CMS Administrator Dr. Donald Berwick, related to ZPICs, available at this hyperlink.

HCLA will have presentations on these topics and more at the HCLA Annual Conference at the Crowne Plaza in Baton Rouge this coming Tuesday and Wednesday. Major issues abound for home health and progressive providers will be there to participate in the important conversations. Join us for invaluable information, multiple networking opportunities, and the trade show with the vendors who are in the know about the road ahead. Your competitors will be there getting as much information as possible. Can you afford to miss this opportunity? We’ll see you in Baton Rouge.