NEWS ALERT: CMS Allows Remote Delivery

Federal authorities have decided that telephonic communications is an acceptable alternative to in-person meetings.

EDITOR’S NOTE: With looming shortages of personal protective equipment (PPE) and an unknown asymptomatic period associated with COVID-19 infection, hospitals around the country have been doing everything possible to preserve stocks of PPE and minimize contact with patients, taking precautionary measures including the use of telehealth by doctors to communicate with patients. RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the recent guidance from the Centers for Medicare & Medicaid Services (CMS).

One area of contention in the healthcare industry of late has been the delivery of federally mandated notices to patients, including the Important Message from Medicare (IMM) and the Medicare Outpatient Observation Notice (MOON), according to Dr. Ronald Hirsch.

“These notices are generally delivered in person, with a verbal explanation and a signature obtained to document delivery,” Hirsch said, noting that with COVID-19, “it made little sense to deliver such notices in person. Many hospitals had already chosen to deliver the notice explanations verbally by telephone, and then have a caregiver deliver a copy of the form the next time the room was entered.”

Hirsch said that others felt that this was a violation of patient rights, and insisted their staff members enter the room – even though at least one social worker was reported to have developed COVID-19 after meeting with a patient who was in the asymptomatic phase.

“To quote one case manager director from a user group, ‘as part of the patient care team, I (and my CNO) believe an in-person assessment by social workers or case managers can reveal much more than a phone call,” Hirsch said, referring to a post on the user group listserv. “Facial expressions, body language, physical condition (unkempt, frailty, etc.) can show if someone is having grief issues, loneliness, self-care deficits, whether they are really comprehending what you are talking to them about, etc. Also, how much do older people especially trust someone over the phone? How do you have an end-of-life/hospice/DNR (do not resuscitate) talk with a patient over the phone? It just doesn’t seem right to me.’”

Fortunately, CMS has now released guidance in an MLN Connects special edition on March 26, stating:

If you are treating a patient with suspected or confirmed COVID-19, CMS encourages the provider community to be diligent and safe while issuing the following beneficiary notices to beneficiaries receiving institutional care…

In light of concerns related to COVID-19, current notice delivery instructions provide flexibilities for delivering notices to beneficiaries in isolation. These procedures include:

Hard copies of notices may be dropped off with a beneficiary by any hospital worker able to enter a room safely. A contact phone number should be provided for a beneficiary to ask questions about the notice, if the individual delivering the notice is unable to do so. If a hard copy of the notice cannot be dropped off, notices to beneficiaries may also delivered via email, if a beneficiary has access in the isolation room. The notices should be annotated with the circumstances of the delivery, including the person delivering the notice, and when and to where the email was sent.

Notice delivery may be made via telephone or secure email to beneficiary representatives who are offsite. The notices should be annotated with the circumstances of the delivery, including the person delivering the notice via telephone, and the time of the call, or when and to where the email was sent.

“It should be noted that these notices must still be delivered; even a national emergency does not allow hospitals to violate patient rights unilaterally,” warned Hirsch. “But the mode of delivery was what was in question here. As this pandemic was unfolding, David Glaser, a RACmonitor editorial board member, stated (that) ‘extraordinary times requires extraordinary measures.’”

Hirsch said it was clear to him that the hospitals that preserved PPE while also protecting beneficiary rights by delivering the notices by phone were doing the right thing, even without the specific CMS authorization.

“I hope all others will follow, now that CMS has spoken,” said Hirsch.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

This Leap Year, celebrate success with a 29% discount one day ONLY! Use code LEAP24 on February 29th at checkout to unlock this offer! Click here to learn more.
It’s Heart Month! Use code HEART24 at checkout to receive 20% off your cardiology products. Click here to view our suite of Cardiology products!