Hospitals continue to be a major source of referrals for home health agencies, hospices, HME companies and hospices. But home care providers often encounter a number of difficulties in their relationships with hospitals. Post-acute providers that are free standing perceive that hospitals do not honor a patient’s right to freedom of choice. Agencies also encounter instances in which they are asked to pay fees to gain access to e-discharge systems or to hospitals by paying fees to third-parties that credential vendors. In addition, hospitals are increasingly interested in preferred provider relationships with post-acute providers. What are hospitals required to do with regard to patients’ right to freedom of choice? What should agencies do when patients’ rights are violated? Are agencies allowed to pay fees to participate in e-discharge systems according to recent guidance from the OIG? What about paying fees to vendors? What is a Preferred Provider Agreement and how does it work? As always, the emphasis will be on practical guidance.

Objectives:  
(1)  Describe what hospitals must do to protect patients’ right to freedom of choice of providers.
(2)  Describe recent guidance from the OIG about e-discharge systems.
(3)  Identify one key provision of Preferred Provider Agreements with hospitals.

Assisted living facilities (ALFs) and independent living facilities (ILFs) continue to be concerned about keeping residents in their apartments in view of the difficulty potential new residents have in selling their homes in this economy. ALFs and ILFs want to maximize the use of all types of post-acute services, including home health agencies, hospices, private duty agencies and HME companies. Post-acute providers of all types may certainly establish a variety of different relationships with ALFs/ILFs, including Preferred Provider Agreements and space rental arrangements, but must be careful to meet all applicable federal and state regulatory requirements. The purpose of this audio conference is to assist providers to understand and comply with these requirements so that they can establish productive relationships with these types of communities.

Objectives:
(1) Describe what constitutes a kickback.
(2) Identify one key provision of Preferred Provider Agreements.

Physicians continue to be a prime source of referrals for home health agencies, hospices, private duty agencies and HME companies. Relationships with physicians who make referrals are, however, highly regulated. Most post-acute providers must meet the requirements of both the federal Stark laws and the anti-kickback statute in their relationships with physicians who make referrals. What requirements must be met to pay referring physicians for consulting services? How much can consulting physicians be paid? What documentation do providers need regarding services provided by referring physicians? What items can providers give to referring physicians? How much can they cost? The purpose of this audio conference is to provide practical guidance regarding these and other questions.

Objectives:
(1) Describe one requirement of the Stark law and regulations regarding giving items to physicians.
(2) Identify one type of documentation needed from referring physicians to verify services provided for which they are paid.