Home Health & Hospice Week

CMS sets dialysis supplies fee schedule.

The proposed rule implementing the DMEPOS competitive acquisition program--i.e, competitive bidding--outlines other provisions that should be on suppliers' radar screens.

These include a new fee schedule for home dialysis supplies and equipment that are still paid on a reasonable charge basis, according to the rule proposed by the Centers for Medicare & Medicaid Services.

The rule also clarifies federal policy on the scope of the statutory eyeglass coverage exclusion and implements a revised methodology for calculating fee schedule amounts for new DMEPOS items.

• If you're looking for ways to improve recruitment and retention of direct care workers, the government wants to help. CMS has created the Nation-al Direct Service Workforce Resource Center "to res-pond to the large and growing shortage of workers who provide direct care and personal assistance to individuals who need long term supports and services in the United States," the Center's Web site says.

The Resource Center provides technical assistance to state and local governments, non-profits, em-ployers and professionals who want to improve the recruitment and retention of direct care workers in their states. The Web site is at www.dswresourcecenter.org.

 • Medicare generally doesn't cover the osteo-porosis drug Forteo under the home health benefit, Palmetto GBA's April bulletin to providers explains. That's because Forteo is supposed to be given daily for up to two years, which doesn't have a finite end point and so doesn't meet home health's intermittent criteria, the regional home health intermediary says.

However, some exceptions to the coverage prohibition do occur. If a home health agency can establish a finite end point for the Forteo injections--say, because the patient's daughter will learn to give them--Medicare would cover it, Palmetto says.

Also, if a family member could provide the injections on at least some days of the week, the HHA could provide them on the other days. "Since skilled nursing care is provided less than daily, this does meet the intermittent criteria," Palmetto concludes.

• For-profit hospice chain VITAS' earnings were up in the most recent quarter, according to Cincin-nati-based parent Chemed Corp. VITAS recorded a $10.9 million income on $168.4 million in revenues for the quarter ended March 31, compared to a $9.6 million profit for the same period in 2005, Chemed says.

Overall, Chemed Corp. recorded a $12.2 million profit on $246.2 million in revenues for the time period, compared to an $8.1 million profit on $218.6 million in revenues for the year-ago quarter.

VITAS' average daily census increased 10 percent to 10,480 in the quarter and average length of stay was 70 days.

• Matria Healthcare Inc. has seen a significant jump in revenues, thanks to its acquisition of fellow disease management company CorSolutions in the latest quarter. Matria reported net earnings of $4.9 million on revenues of $80.9 million for the quarter ended March 31, compared to a $3.8 million profit on $39.6 million in revenues for the same period in 2005.

But executive shakeups, reduced earnings forecasts and other problems are giving the Marietta, GA-based company problems. Short-sellers recently have driven down the price of the company's stock.

• VNA-TIP HomeCare of Alton, IL has acquired Great Rivers Home Care of St. Peters, MO for an undisclosed cash purchase price, reports the St. Louis Post-Dispatch. VNA-TIP now has 16 offices in eastern Missouri and southern Illinois, the paper says.

 • The U.S. Attorney's Office in New Haven, CT has closed its investigation into possible federal law violations by National Home Health Care Corp.'s Connecticut subsidiary, the Scarsdale, NY-based company says in a release.

NHHC first announced the investigation, which addressed psychiatric nurse practices, when it received a related subpoena in 2003 (see Eli's HCW, Vol. XII, No. 40).

• A jury serving in U.S. District Court in Texas has handed down the latest conviction involving durable medical equipment fraud.
 
The owner of Rooster Medical Equipment and Supplies, a DME company in Fort Worth, TX, was convicted April 20 on five counts of health care fraud, according to a release from Texas U.S. Attorney Richard B. Roper. The conviction of defendant Bassey Jackson "B.J." Ekanem came after a one-and-a-half-week-long jury trial in U.S. District Court in Dallas. Among the charges: obtaining patient information from Medicare beneficiaries and using that information to submit fraudulent claims to Medicare for DME. The scheme included furnishing inexpensive scooters to beneficiaries while billing Medicare for much more expensive K0011 power wheelchairs and related accessories.

Over a period of 18 months, Rooster Medical billed Medicare for K0011 power wheelchairs and accessories in excess of $1.7 million, Roper says.

• A Fair Labor Standards Act case against a Louisiana HHA owner has resulted in rare criminal charges being filed.
 
The U.S. Attorney's Office in Lafayette has charged Joseph Russo II, owner of Youngsville-based Community Home Health Care, with a misdemeanor charge of failure to pay $31,184 in overtime to 26 employees from 2002 to 2005, reports The (Acadiana) Advocate.

If convicted, Russo could face up to $10,000 in fines. Russo already made full restitution to the employees, mainly LPNs, when the Department of Labor ruled against him in the case, his attorney William Goode told the newspaper. Community paid the nurses per visit but still was liable for overtime pay.