Home Health & Hospice Week

FISS update changes the way you enter RTP corrections.

If you're having problems fixing your returned Medicare claims, you'd better check out the new protocol for claims corrections.
 
A Fiscal Intermediary Shared System release has changed the way you should make corrections to revenue code lines on claims that have been returned to provider (RTP'd), regional home health intermediary Cahaba GBA says in a Sept. 7 posting to its Web site.

Instead of typing over incorrect information on a revenue code line, you need to delete the incorrect line and re-key the correct information, Cahaba instructs.
 
To add correct information, you must "re-key the corrected information below the 0001 Total Charges line and then press the HOME key on your keyboard," RHHI Palmetto GBA explains in a Sept. 8 posting to its site. Then you must delete the incorrect information by keying the letter "d" anywhere on the erroneous revenue code field and pressing the HOME key on your keyboard.
 
More details are at www.palmettogba.com and www.iamedicare.com/Provider/newsroom/whatsnew/20050907_rtp.htm.

 • The Centers for Medicare & Medicaid Services has received from a contractor a draft proposal on applying business and product-quality standards to durable medical equipment suppliers, the agency said in its recent Open Door Forum on power mobility equipment (see story, p. 260). The agency will hold an Open Door Forum on the standards proposal Sept. 26. The proposal is online at www.cms.hhs.gov/suppliers/dme pos/compbid/default.asp.

 • Airlines would have to provide free medical oxygen to passengers in need under a new rule proposed by the Department of Transportation. Published in the Sept. 7 Federal Register, the rule would modify the Air Carrier Access Act of 1986, which prohibits discrimination in airline service based on disability.
 
Carriers are not currently required to provide oxygen to passengers, and those that do usually charge a fee that can be "prohibitively expensive," according to the DOT. One study cited by the agency said the costs for supplied oxygen range between $64 and $1,500 per trip.
 
The rule would also require all airlines except for air taxis to test ventilators, respirators, continuous positive airway pressure devices and certain portable oxygen concentrators to ensure they don't cause electromagnetic interference with aircraft navigation and communications equipment. Passengers would be allowed to use devices that can be safely operated on board. The proposed rule and comments are at http://dms.dot.gov, docket number OST-2005-22298.

 • Louisville, KY-based HealthEssentials Solutions Inc. is paying $1.85 million to settle False Claims Act fraud charges first brought by three different whistleblower lawsuits in 2003 and 2004.
 
To obtain the $1.85 million, the company that is in Chapter 11 bankruptcy is selling its home care subsidiaries, the U.S. Attorney's Office for the Western District of Kentucky says in a release. Those include Specialized Home Healthcare Services of Central Florida Inc., MAJJ Enterprises, Best Choice Home Care Naples, and HealthEssentials Home Care.
 
The government will release the HES home health agencies from any civil or administrative monetary claims in exchange for the $1.85 million ...quot; if the bankruptcy courts agree to the arrangement. HES' other units and officials remain under investigation and subject to liability, the release says.

 • The Washington-based National Coalition for Assistive and Rehab Technology has launched a Medicaid project that will work through the legislative and regulatory systems to ensure beneficiaries have access to needed rehab and assistive technology goods and services. The effort will also work to secure funding that takes into account services associated with seating and wheeled mobility products.
 
"Adequate and timely reimbursement from state Medicaid programs is critical to rehab technology companies, and without it, consumers lose access to medically needed products and services," notes Rita Hostak, NCART president and vice president of government relations for Carlsbad, CA-based Sunrise Medical. "Medicaid cuts are threatening the rehab industry."

 • NationsHealth's loss is Lincare's gain. Sunrise, FL-based NationsHealth has sold its respiratory division to Clearwater, FL-based Lincare Holdings Inc. for $16 million and will transfer its respiratory patients and related inventory to Lincare.
 
The sale agreement calls for NationsHealth not to get involved in sales and marketing of respiratory equipment and medication for five years, and for Lincare to refrain from marketing or advertising diabetes or ostomy services to certain customers for three years, the Tampa Bay Business Journal reports.

 • Hospices continue to change hands at a brisk pace. Scottsdale, AZ-based VistaCare Inc. plans to acquire this month Lovelace Sandia Hospice in Albuquerque, NM for $4.5 million. The acquisition from Lovelace Sandia Health System and its Nashville, TN-based parent Ardent Health Services should add up to 90 patients to VistaCare's census, the company says in a release.
 
And Nashville-based Alive Hospice Inc. has purchased Hospice of Murfreesboro from Middle Tennessee Medical Center for an undisclosed amount. Hospice of Murfreesboro will keep its name, Alive says in a release.

 • Gentiva Health Services Inc.'s managed care unit is terminating its contract with military health plan TriWest Healthcare Alliance Nov. 29. CareCentrix's contract with TriWest "is no longer viable," Gentiva senior VP Mary Morrisey Gabriel says in a release.
 
The relationship isn't completely dead, however. "Although no new agreement has been reached, we are currently exploring the possibility of a mutually beneficial contract," says Gabriel, also Gentiva's Chief Marketing Officer.

 • A wheelchair supplier who decried fraud is going to jail for committing it. Scott Michael Vogelsang, who in 2001 wrote an op-ed titled "When Fraud is Okay," has been sentenced to 33 months in federal prison after a grand jury found him guilty of cheating Medicare and Medicaid out of nearly $170,000, the Sacramento Bee reports. Vogelsang, who criticized suppliers' lack of protection from dishonest patients, must also pay the government restitution.
 
Vogelsang intentionally submitted incorrect claims to Medicare, knowing that his durable medical equipment regional carrier would reject them, prosecutors allege. He then submitted the claims to Medi-Cal and received 100 percent of their value, the Bee reports.