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The recently enacted health care reform package might make cuts to home care payments in the long run, but in the short run it could raise your Medicare rates.

For episodes ending on or after April 1,Medicare will add 3 percent to rural home healthagency payments, the Centers for Medicare & Medicaid Services confirms in a message to providers. Unlike previous add-ons which were limited in time, this add-on's expiration date is relatively far off at Dec. 31, 2016.

How it works: "Claims that report a rural state code (code beginning with 999) as the Core Based Statistical Area (CBSA) code for the beneficiary's residence will receive the additional 3 percent payment," CMS explains in the message. "The CBSA code is reported associated with value code 61 on home health claims."

Don't expect to see the additional dollars going into your wallet quite yet, however. CMS hasn't yet made the system changes to modify payments for add-ons.

CMS "is working to expeditiously implement the home health rural add-on provision," the agency says. "Be on the alert for more information about this provision and its impact on past and future claims."

• Durable medical equipment suppliers and other Part B providers are getting more help from CMS and its contractors on a few physician-related fronts.

First, CMS is using a new MLN Matters article to encourage physicians that order DME or refer for Part B services to enroll in PECOS.

Starting Jan. 3, the Medicare claims system will reject claims if the ordering/referring physician on the claim isn't enrolled in the Medicare Provider Enrollment, Chain, and Ownership System. That deadline was moved back from April 5 after much complaint from providers and physicians (see Eli's HCW, Vol. XIX, No. 9, p. 69).

"If you order or refer items or services for Medicare beneficiaries and you do not have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS), you need to submit an enrollment application to Medicare," CMS says in the article online at .

It can take 60 days or longer for PECOS applications to be processed, CMS tells physicians in the article. So they shouldn't wait until the last minute to put in applications.

Also: Medicare contractor NHIC, the DME Medicare Administrative Contractor for Region A, has sent physicians letters urging them to cough up documentation for CERT reviews of DME.

"Please respond to any Comprehensive Error Rate Testing (CERT) documentation request [you] receive from CERT or the providing supplier," NHIC said in the letters, which were sent out from the "DME MAC CERT Education Task Force."

Suppliers can only furnish the CERT contractor with documentation the physician gives them, the letter stresses. Therefore, for suppliers to continue furnishing items to beneficiaries, they must be able to rely on physicians for requested documentation, the letter tells docs.

The letters sent for different DME categories are in National Government Services' April newsletter to providers at .

• Get ready for a shorter deadline to submit Medicare claims. Providers now have one calendar year after the date of service to file a claim with Medicare, CMS notes. The change was included in the recently enacted health care reform legislation, the Patient Protection and Affordable Care Act (PPACA), with the aim of reducing fraud, abuse, and waste.

The deadline applies to services and items furnished Jan. 1, 2010 and later. From Oct. 1 to Dec.31 of 2009, providers have until Dec. 31, 2010 to file claims.

Stay tuned: CMS may establish exceptions to the one-year filing deadline in future rulemaking, the agency says.

• In your eagerness to appeal a denied claim, don't forget the first step. Qualified Independent Contractor First Coast Service Options says it is dismissing many second-level reconsideration appeals because the provider hasn't received a first-step redetermination notice from its Medicare contractor.

Some providers are confused over the appeals process steps, First Coast says in the NGS April newsletter for providers. But others are mixing up written or phone inquiry responses from MACs with official redetermination notices.

Tip: The official Medicare Redetermination Notice (MRN) should include the date of the original decision, a clear statement of the "favorable, partially favorable, unfavorable, or dismissed"  decision, and information on further appeal rights including the QIC address.

Providers have 120 days from receiving the remittance advice to request a redetermination notice, First Coast notes in the newsletter. "You do not get extra days if you send it to the wrong entity," the QIC emphasizes.

• Don't stress over trying to get a verbal hospice certification narrative within two days of the start of care. So says a recent Frequently Asked Question from CMS.

When obtaining verbal certification or recertification, you don't have to secure a verbal narrative justifying the six-month prognosis at the same time, regional home health intermediary Cahaba GBA notes on its Web site. "While a verbal narrative is not required as part of the oral certification/recertification, the written narrative is required prior to filing a claim," CMS says in FAQ 9969.

Also, remember that "the essence of what the written narrative will ultimately entail in its explanation of the clinical findings that support a life expectancy of 6 months or less, is expected to bethe basis for the oral certification/recertification," CMS adds.

• If you're having trouble with your claims returning to provider with reason code 38107, a new job aid from RHHI Palmetto GBA may help you out.

Home health agencies receive RTP'd claims with reason code 38107 when the claims system can't find a request for anticipated payment (RAP) that matches the final claim you submitted, Palmetto explains. Reasons for the problem could be that you never filed the RAP, the RAP auto-canceled due to timing out, or certain claim fields on the RAP and final claim don't match.