Home Health & Hospice Week

Physician focus may translate to quick HHA changes too.

Don't get too used to the 2006 payment increase you've started seeing for home health episodes ending Jan. 1 and later.

The Centers for Medicare & Medicaid Services has indicated in a Jan. 6 letter to congressional leaders that it is ready to change Medicare payment rates within two days of pending budget legislation becoming law. And CMS automatically will reprocess all the physician claims paid at the current 4.4 percent cut rate when the legislation bringing payment levels to a 0 percent inflation update is passed.

However, the letter sent to Reps. Bill Thomas (R-CA) and Dan Burton (R-IN) and Sen. Charles Grassley (R-IA) addresses only physician payments. It remains unclear how fast CMS would institute payment changes for home health agencies, including a rollback of the current 2.8 percent increase for all HHAs and a 5 percent rural add-on for agencies serving rural patients.

President Bush is urging the House to finish work on the budget reconciliation package quickly when it reconvenes Jan. 31.

HHAs' hopes of getting the 2006 payment freeze reversed in the House may be further weakened by the Medicare Payment Advisory Commission's final vote to recommend yet another pay freeze for 2007 rates. MedPAC approved the recommendation in its Jan. 10 meeting.

The influential advisory body to Congress proposed the 2007 recommendation in December (see Eli's HCW, Vol. XIV, No. 44).

• The U.S. Supreme Court may soon weigh in on overtime rules for certain home care workers.

The U.S. Solicitor General recently recommended the Court accept an appeal and reverse a lower court's ruling in In Long Island Care at Home, LTD., et al v. Evelyn Coke, reports the National Association for Home Care & Hospice.

At issue in the case is whether the federal labor regulation exempting HHAs' home care aide services from overtime compensation requirements is invalid. "The submission by the Solicitor General gives great hope to efforts to get the Supreme Court to hear the case," NAHC cheers.

• The nation's largest home health company is about to get substantially larger.

Gentiva Health Services Inc. has agreed to buy The Healthfield Group Inc. for $454 million in cash and stock. The transaction will push Gentiva's annual revenues past the $1 billion mark, the Melville, NY-based company says.

Atlanta-based Healthfield has 130 locations in eight southeastern states plus Michigan, Gentiva says in a release. Healthfield offers home nursing, hospice, durable medical and respiratory equipment, and infusion therapy services.

"Our combination with Healthfield will substantially extend our ... geographic reach in the southeast, and include significant operations in four key states with certificate of need requirements," Gentiva CEO Ron Malone says in the release. "It will make Gentiva one of the nation's 10 largest hospice providers."

• Amedisys Inc. has purchased seven HHAs from ASAP Health Services, a division of The Schuster Group, the Baton Rouge, LA-based company says in a release. Amedisys paid $2.1 million in cash and a $0.6 million promissory note payable over three years for the central Oklahoma agencies that generate about $4 million in annual revenues.

• Deerfield, IL-based drugstore chain Walgreen Co. has announced its store count now includes 36 home care division locations compared with 31 such locations last year.
 
Total sales for the chain rose 10.2 percent to $15.38 billion from $13.95 billion for the four months of the fiscal year to date, the company says.

• VITAS Innovative Hospice Care has received Medicare licensure for its program in North Bay, CA, the Miami-based company says in a release. The Petaluma location serves patients in Sonoma and Marin counties.

• Wizzard Software has signed a letter of intent to acquire a second Interim Healthcare HHA. The Pittsburgh-based software company plans to market its health care technology products by demonstrating their usefulness to the agencies it has bought.

• A former VNA manager has been sentenced to 15 months in federal prison after embezzling more than $900,000 in a false invoice scheme.

Robert Caruso, former director of administrative support services at the Visiting Nurse Association of Central Jersey Inc. in Red Bank, also has to repay about $300,000 more to the VNA. Caruso already has repaid nearly $630,000, according to U.S. Attorney Christopher J. Christie. Caruso pled guilty to a bogus contractor billing scam in September (see Eli's HCW, Vol. XIV, No. 37).

• Four men involved in a $3 million Medicare durable medical equipment fraud scheme have been sentenced to jail time and ordered to pay a combined total of nearly $8 million in restitution by a Miami federal judge.

Lazaro Alberto Martinez, Virgilio Miranda, Alfredo Hernandez Rivera and Lemay Chang Barcelo were charged in September 2005 with three separate conspiracies to commit health care fraud, obstruct justice and tamper with a witness, and commit money laundering.

Among other charges, Miranda and Martinez allegedly paid Chang $70,000 to leave the country and thus avoid testifying before a grand jury convened to investigate an alleged fraud scheme involving two Miami DME companies, AID Medical Equipment Inc. and Progressive Services Inc.