The New York State Office of the Medicaid Inspector General (OMIG) contracts with the University of Massachusetts Chan Medical School (UMass Chan) to administer the Medicare Home Health Appeals Initiative. Under this initiative, providers are required to seek reimbursement from Medicare and all other liable third parties for home health services rendered to dual eligible Medicare/Medicaid beneficiaries in accordance with 18 NYCRR 540.6(e).

Letters have been sent to certain Certified Home Health Agencies (CHHAs) for the Federal Fiscal Year (FFY) 2022 Medicare Home Health Maximization Services Initiative.

Providers contacted for this initiative will receive a Demand Bill Directive like this sample document. This directive has been sent to all providers who have been selected to submit claims to Medicare for the second half of the FFY 2022 Medicare Home Health Maximization Services Initiative. The Episodic Payment System (EPS) claims selected for this initiative fall between April 1, 2022 and Sept. 30, 2022, or until the end of the episodic period billed to Medicaid. 

Providers with questions may contact Erin Devaney of UMass Chan at 617-886-8219.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871