New emphasis on patient release forms for complex rehab
YARMOUTH, Maine – If complex rehab providers want to help preserve access to equipment and services for Medicaid recipients, they need to do a better job getting patients to sign release forms, industry stakeholders say.
NCART’S Medicaid Committee has been working to challenge denials and overturn negative policies in various states, but without release forms, its efforts often hit a wall.
"That's been our biggest issue," said Rita Hostak, an executive committee member for NCART and vice president of government relations for Sunrise Medical. "They're the only ones with the right to challenge—not the supplier, manufacturer or even the clinician."
Patients often hesitate to sign release forms, stakeholders say, because they don’t want a legal battle that might impact their ability to get benefits.
That’s why providers should make release forms part of the intake process—instead of trying to convince patients after they’ve been denied equipment to sign the dotted line, stakeholders say.
"Afterward, it's hard to try to explain the process when the patient's in a negative, stressful situation," said Hostak.
The other hurdle for NCART’s Medicaid Committee, stakeholders say: Clinicians aren't documenting the need for certain equipment when they know it won't be covered, which leaves NCART without proof of a problem.
"I can't challenge (a policy) if the need was never documented," said Hostak.
NCART is spreading the word that providers should have release forms and proper documentation in place in case they need to fight for their patients, something that’s likely to happen more and more frequently.
"Medicaid's always been an issue," said Don Clayback, executive director of NCART. "In the past year, states—as they continue to wrestle with their budget pressures—are being forced to take more drastic measures when it comes to their budget."