Tuesday, December 31, 2002

A patient’s right to choose: What you need to know
Q: What do HME suppliers need to know about a proposed new condition of participation (COP) for hospitals related to patients’ rights to choose their providers?

A: BBA’97 requires hospitals to develop a list of home health providers that are Medicare certified, as well as provide services in the area in which a patient resides or in the area in which a patient asks to be included on the list. In addition, BBA requires hospitals to indicate that they have a financial interest in entities included on the list that are owned/ affiliated with hospitals. It is unclear whether this section of the BBA also applies to HME companies. Recently, however, CMS proposed a new COP for hospitals. In the commentary to this proposed COP, CMS makes it clear that it wants to promote patient choice not only with regard to home health agencies but for “other entities” as well. In addition, the language of the COP states that if a hospital refers a Medicare beneficiary to an HHA or other entity in which the hospital has a financial interest or vice versa, CMS will make available to the public information that is intended to assist patients to exercise their right to freedom of choice of providers. Based on this proposal, it now appears that the BBA may apply to patients’ right to choose an HME company.

Attorney Elizabeth Hogue is in private practice. Reach her at 301-421-0134.