HHA Toll-Free Hotline and Investigative Unit

3330 - HHA Toll-Free Hotline and Investigative Unit (Rev. 1, 05-21-04) Section 1864(a) of the Act requires that the State establish a toll-free hotline to collect, maintain, and continually update information on Medicare participating HHAs including certification-related deficiencies found regarding patient care, corrective actions, and sanction activity during its most recent survey. Complaints and questions will also be received over the hotline concerning HHAs in the State. The State is to inform Medicare beneficiaries of the availability of the hotline, its purpose, the hotline telephone number, and hours during which it is in service. The SA (under the §1864 agreement) may subcontract with the appropriate State or local agency for operation of the toll-free hotline. However, the SA is required to investigate certification-related complaints received by the hotline. The instructions are minimum requirements for establishing and maintaining the hotline. Additional operating procedures may be used to complement the requirements. This activity will be monitored by the RO and enforced through the §1864 agreement process. 3330A - HHA Hotline Function (Rev. 1, 05-21-04) • Operate the toll-free hotline 6 hours per day (between 7:00 a.m. - 6:00 p.m.) Monday - Friday, except on State or Federal holidays. Notify the public in advance if there are changes in hours of operation; • Provide HHA hotline information to HHAs and the public by telephone or in writing; • Record most recent certification and enforcement findings regarding patient care within 30 calendar days of the determination of certification or recertification, approved PoC, correction of deficiencies, and any sanctions imposed, including termination of a Medicare participating HHA; • Record complaints received on the HHA hotline; • Refer HHA hotline certification-related complaints to the survey unit for possible investigation; and • Refer non-certification related complaints to the appropriate components in the State agencies. 3330B - HHA Hotline Information (Rev. 1, 05-21-04) These items must be maintained and readily retrievable: • Name, address, and Medicare provider number of Medicare HHAs in the State; • Date of most recent Medicare certification or recertification survey of individual HHAs; • Record of any Condition level deficiencies found regarding patient care in the most recent survey conducted by the SA; • Date(s) of planned corrective action(s) and completed corrective action(s) for Condition level deficiencies; and • Date(s) and type of sanction(s), if any imposed, including termination. 3330C - Disclosure of Information (Rev. 1, 05-21-04) When responding to calls requesting information, the SA releases the information verbally and as necessary in writing in accordance with CMS public disclosure rules. (See §§3300-3320.) 3330D - Record Keeping Requirements (Rev. 1, 05-21-04) The SA records each call as either a complaint or a general inquiry. The record keeping system may be manual or automated and must indicate the general nature of the inquiry or complaint and the resolution, i.e., question answered, material sent, or complaint referred for investigation. 3330E - Public Awareness (Rev. 1, 05-21-04) The State is to notify Medicare beneficiaries and HHA’s of the availability of the hotline. In addition, the State is to notify each Medicare HHA’s about the HHA hotline, the telephone number, purpose, and hours of operation. 3330F - Hotline Investigative Unit (Rev. 1, 05-21-04) The SA investigates the certification-related complaints received by the hotline following procedures in SOM Chapter 5. In instances where a complaint is not certification-related, the SA refers that complaint to the proper State agency (e.g., the State medical society, the State licensure agency, or the State social services department), or the RO. Response to Subpoenas Served On and Suits Against the State Agency