Today’s (January 23, 2012) issue of Home Health Line reports that “pressure from government auditors may lead to the revival” of the TPL demonstration that ran for seven years in Massachusetts, Connecticut and New York and that handled resolution of home health payments through a sampling rather than a case by case medical review. The source of this information is an unnamed “industry official. ”
At this point in time, the Home Care Alliance has not heard of any specific intent to reinstate the demonstration – although we have asked that it be done in meetings at CMS in Washington and locally, and in comments to the new federal office examining care for dual eligibles. The Alliance has been invited to present issues with the current TPL process at meeting at CMS Boston office in mid-February.
Prior to the February meeting at CMS, the Alliance has meetings scheduled with NHIC and MassHealth to discuss process and recoupment issues. In previous direct emails, we have asked that members who have cases in which recoupments were made in error, HHABNs were lost or mishandled, or records were lost or mishandled to please provide this information in as much detail as possible to either Tim Burgers or Pat Kelleher, as soon as possible.
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