Home Health & Hospice Week

Majority of Senators sign letter of support.

Home health agencies may succeed in staving off reimbursement cuts. A letter circulating in the Senate calling for no cuts to home care and hospice now has a solid majority of senators' names on it, reports the National Association for Home Care & Hospice in its Sept. 12 bulletin.

The letter was spearheaded by Sens.Susan Collins (R-ME) and Russ Feingold (D-WI). Others signing on include Sens. Tom Carper (D-DE), Mark Pryor (D-AR), Joe Lieberman (D-CT), Saxby Chambliss (R-GA), Evan Bayh (D-IN), Conrad Burns (R-MT), Chuck Hagel (R-NB), Byron Dorgan (D-ND), Mark Dewine (R-OH), Tim Johnson (D-SD) and George Allen (R-VA).

The Medicare Payment Advisory Commission has recommended a freeze on home health payment rates four years in a row.

• Help may be on the way for rural home health agencies trying to update their information technology (IT).

Reps. Greg Walden (R-OR) and Earl Pomeroy (D-ND), co-chairs of the House of Representatives Rural Health Care Coalition, recently introduced H.R. 6030, the "Health Care Access and Rural Equity Act" (HR 6030).

The bill would extend several expiring Medicare payment adjustments for rural practitioners, including rural home health agencies, and authorize health IT grants for rural practitioners, among other provisions.

This bipartisan legislation, introduced with 60 cosponsors, is endorsed by the National Association for Home Care & Hospice.

• Health care providers now have an at-a-glance guide for how to make decisions related to the HIPAA privacy rule in an emergency situation.

Created by the U.S. Department of Health & Human Services, the tool takes HIPAA-covered entities through the decision-making process.

Home health agencies and other covered entities can use the document in the event of a natural disaster or other emergency to ensure that protected information is disseminated appropriately.

To access the tool, go to www.hhs.gov/ocr/hipaa/decisiontool/EmergencyPrepDisclose.pdf.

• Three medical supply company owners from Miami, FL, were arrested in connection with two alleged schemes that billed Medicaid some $183,000 for equipment that either was not prescribed or not received by patients, Florida Attorney General Charlie Crist announced Sept. 7.

Charged in Miami-Dade County Circuit Court with organized fraud and grand theft were Arnaldo Iglesias, former owner of I. Cowan Medical Equipment and Supply Corp., and Jorge Fernandez-Romero and Alain Fernandez, former owners of JC Medequip & Supplies Inc., said Crist in a  written statement.

Iglesias allegedly billed Medicaid $121,000 for colostomy and catheter supplies that were not prescribed by providers whose names appeared in the billings, according to a statement by Crist.

Fernandez-Romero and Fernandez allegedly billed Medicaid nearly $62,000 for prosthetic devices that were not provided, the statement added.

• Billing for a visit during which you administered both the influenza and PPV vaccines? Be sure you have the right diagnosis code or you'll wind up with a denial. Report diagnosis code V06.6 on claims that contain influenza virus and/or PPV vaccines and their administration when the purpose of the visit was to give both vaccines, coaches CMS in a new MLN Matters article.

The change is effective Oct. 2.

For more information, see the new MLN Matters article on the topic at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5037.pdf.

• A lower court erred in determining a health care consultant and two home health agencies caused no loss to Medicare because no crime was committed, a federal appeals court said Sept. 5.

The U.S. Court of Appeals for the Eleventh Circuit held that Medicare's willingness to pay up to its cost caps did not absolve Mahendra Pratap Gupta from his violation of the related party regulations or from his liability for submitting false claims to Medicare. The amount the government paid in response to the false claims was an appropriate measure of damages, the appeals court concluded.

"The court's belief that no crime was committed does not nullify its duty to calculate the [U.S. Sentencing] Guidelines loss amount. Moreover, the purpose of the related party rule is to prevent the payment of artificially inflated consulting fees," said Judge Eugene E. Siler Jr. of the U.S. Court of Appeals for the Sixth Circuit.

"The 'no harm, no foul' argument culminating in a calculation of no loss to the government has been regarded as an insufficient rationale by which to calculate loss," he added.

Text of the court's decision is available online at www.ca11.uscourts.gov/opinions/ops/200416091.pdf.