Revised draft CHHA audit protocols - January 15, 2013

Revised draft CHHA audit protocols

Last week LeadingAge New York and other associations met with staff from the Office of the Medicaid Inspector General (OMIG) to discuss our concerns with the draft Certified Home Health Agency (CHHA) audit protocols. As a result of the meeting, we received a revised version of the protocols on Jan. 11 and were requested to comment on them by Jan. 16. During the meeting, OMIG clarified that the protocols will apply to claims through Dec. 31, 2010.

Some of the issues raised during the meeting included the role of DOH surveillance and OMIG, accounting for spend-down, sampling and extrapolation, and denial of claims for missing pieces in a personnel file.

We have requested to be part of a work group to discuss audit protocols as the DOH moves from a fee-for-service system to managed care, and will keep members apprised of the developments.   

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871