In the News:  Revisit Fees Final Rule Published

As a result of the 2007 Continuing Appropriations Resolution, Public Law No. 110-5, H.J.Res.20, §20615(b)(2007), the Department of Health and Human Services was directed to establish and charge user fees to health care facilities when survey revisits are needed as a result of survey deficiency citations. Survey types affected by these fees include initial certification, recertification, or substantiated complaint surveys.

A validation survey following ACHC, CHAP or JCAHO deemed status surveys is not subject to the revisit fee, as long as the CMS deemed status of the provider remains in place. A second type of visit, not subject to the revisit fee, is the state monitoring visit surveys of providers in the High Risk Provider Enrollment demonstration project in Harris County and Southern California. The exemption from revisit fees is contingent upon whether the provider is found to be deficient in complying with the Medicare Conditions of Participation or coverage.

At this time, revisit user fees only apply to selected Medicare-certified providers and suppliers, but this does include both home health agencies and hospices. Other providers that are also affected by these revisit user fees include ambulatory surgical centers, end stage renal disease providers, critical access hospitals, dually-certified nursing facilities, hospitals, psychiatric hospitals, skilled nursing facilities and rural health clinics.

When CMS conducts surveys and certification visits, these are completed through State survey agencies with the focus on the provider’s compliance with the Conditions of Participation, quality standards, statutory and regulatory requirements and/or conditions for coverage. When deficiencies are found in patient care delivery or processes, it can be determined to be necessary to conduct either additional offsite review of submitted documentation or a revisit to the provider in order to determine that deficiencies cited in the survey report have been addressed and corrected.

The offsite revisit fee schedule is the same for all provider types and has been set at $168.00; however onsite revisit survey fees vary. The onsite revisit fee for home health agencies is $1,613.00 and for hospices the fee is $1,736.00. CMS has indicated that these are cost-based fees based upon the time and effort required of State surveyors to complete follow up, resulting from deficiencies identified in the original onsite survey. The provider can request a reconsideration if they believe there has been an error, but the request for reconsideration must be received within 14 calendar days from the date of the CMS revisit fee provider notice. For more information or to review the Department of Health and Human Services, Centers for Medicare Medicaid document, Establishment of Revisit User Fee Program for Medicare Survey and Certification Activities; Final Rule go to .

Resources:

Federal Register / Vol. 72, No. 181 / Wednesday, September 19, 2007 / Rules and Regulations, pp. 53628-53646.