SNF therapy contracts: Your risks and what you need to know

Q: How long does the SNF need to retain background and licensing documentation of the therapist working for a contract company?

A: The SNF needs to retain background and licensing documentation of the therapist for a contract company for the same amount of time as it does for its employees. You should follow whatever your record retention requirement is for your employees, and there should be a statute of limitation within your state. Usually if the therapist was there, involved in the care and treatment of patients, and anything comes up, there’s no statute of limitation you should know.

With billing fraud, there’s no statute of limitation. On any kind of care fraud, or any kind of abuse and neglect, if those issues arise, I typically suggest that if you’ve got a seven-year statute of limitation, you maintain records for seven years.

Q: Do you recommend shared risk or indemnification clauses for Medicare consultants who come in and make recommendations on RUG levels?

A: Yes, I recommend shared risk clauses for consultants who come in, especially if they’re going to come in on a preemptory basis and decide the RUG levels you should bill. I do expect shared risk. Anybody who’s involved in that Medicare billing process is going to have input into what we bill. That is a contractor separate from the SNF. The SNF can’t essentially indemnify itself. But if the SNF is using somebody to do any of that work and be part of the coding, part of the auditing, and ultimately part of the RUGs, you need to be part of that process of indemnification.

SNF providers need to be part of that process of shared risk?the only way I could make sure that I can indemnify the SNF for the activities of its contractors and anybody who is part of that process is to say, “If you’re going to give me advice and you’re going to be part of this and you’re going to say, ‘Yeah, I’m an expert, I know what ought to be billed, etc.’ and I have to rely on that, my answer is, ‘Okay, I’m happy to do that, but here’s the deal. If in fact you’re wrong and this turns out to be incorrect, you’re going to be responsible for the losses. And at least a portion or a portion thereof, and we’re going to have some shared risk and indemnification as well.’ ”

HCPro.com – Billing Alert for Long-Term Care