§ 366-E — Certified home health agency medicare billing

§ 366-e. Certified home health agency medicare billing. (a) Certified\nhome health agencies shall bill under title XVIII of the federal social\nsecurity act for services provided to all patients eligible for such\nprogram who, as defined by federal law and regulations, are: (i)\nhomebound; (ii) receiving skilled services; and (iii) are receiving such\nservices on an intermittent basis. The department, in consultation with\nthe department of health and representatives of certified home health\nagencies with demonstrated ability to maximize medicare revenue, may\npromulgate regulations to implement this subdivision. Nothing contained\nherein shall be construed to prohibit agencies from billing for medical\nassistance reimbursement for eligible services provided to such patients\nwhich are not covered under title XVIII of the federal social security\nact meeting the standards established by the department pursuant to this\nsection. Patient cases that meet the criteria established pursuant to\nthis subdivision, where coverage has been denied under title XVIII of\nthe federal social security act for the cost of care provided by a\ncertified home health agency shall be referred by such agency to an\norganization pursuant to subdivision (b) of this section.\n (b) The commissioner shall enter into agreements with persons or\nentities to provide for representation of persons meeting the criteria\nspecified in subdivision (a) of this section who have been denied\nreimbursement, under title XVIII of the federal social security act, for\nservices provided by a certified home health agency.\n