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Home Health & Hospice Week

Industry Notes:

DON'T FORGET TO APPLY FOR YOUR NPI

Published on Mon Aug 08, 2005

But you may not want to rush the application, experts warn.

You have a year to apply for a National Provider Identifier, but don't let that lull you into missing the deadline.

Medicare started accepting NPI applications in May and will accept NPIs starting in January, as long as they're accompanied by existing Medicare numbers.

Alert: From October 2006 to May 2007, Med-icare will accept either NPIs or Medicare numbers - but as of May 23, 2007, Medicare will accept only NPIs.

All health care providers including home health agencies, hospices and durable medical equipment suppliers must obtain an NPI.

Some experts advise that you wait at least until September or October this year to apply for an NPI. Although the Centers for Medicare & Medicaid Services web portal is simple to use and relatively straightforward, it may still have some glitches.

If you enter your information into the online form and it isn't working well, you could be dealing with miscues for months, worries consultant Rob Levin with Billing Solutions in Philadelphia. He plans to wait another month before applying on behalf of his clients.

But don't wait too long. Any kind of enrollment application can take longer than you expect, and you don't want to get caught in the crush. Next June, a new crop of medical, dental, pharmacy, etc. grads will burst onto the scene, and they'll all be applying for NPIs.

Graduating students will start to apply for numbers in May, and Medicare often is backed up for four or five months after that, says consultant Jill Young with Young Medical in East Lansing, MI. By the time that bottleneck clears up, everyone who waited will be applying, causing more delays,Young predicts. 

  • A federal judge has given Missouri the OK to quit paying for most durable medical equipment used by adult Medicaid recipients.

    U.S. District Judge Dean Whipple last week declined to grant a temporary restraining order requested by disabled people and advocacy groups that have sued the state over the Medicaid cuts, the St. Louis Post-Dispatch reports. This month the state dropped coverage for equipment such as hospital beds, wheelchair batteries, feeding tubes and walkers for adults on Medicaid unless they are pregnant, blind or in nursing homes.

    A federal lawsuit filed Aug. 29 charges that the state's decision to stop paying for some beneficiaries' equipment is illegal. The state defends the move as financially necessary and says beneficiaries can apply for an exception if they need the equipment to survive.
     
  • Skyrocketing gas prices in the wake of Hurricane Katrina are hitting home care providers squarely in their wallets. Geri Bast, a home health aide for Fairview Home Care and Hospice in Minneapolis, has to fill up her tank about three times a week for work, she told the Associated Press. Bast's 37.5 cents per mile reimbursement rate for travel isn't covering her costs, she complained.

    Rising prices at the pump are squeezing Hart-ford, CT home care worker Yvonne Gayle's already tight budget, reports The Hartford Courant. "If gas keeps going higher I may have to move back to Jamaica, where it is cheaper to live," Gayle told the paper.

    Home care worker Charity Burton of San Jose, CA says she is restricting her non-work-related driving due to high prices, the San Jose Mercury News reports.
     
  • A reminder: suppliers in certain states must work with a properly credentialed professional when furnishing orthotics or prosthetics for Medicare.

    Alabama, Florida, Illinois, New Jersey, Ohio, Oklahoma, Rhode Island, Texas and Washington require that a licensed/certified orthotist or prosthetist  furnish orthotics or prosthetics. Medicare suppliers in those states who plan to submit Medicare claims for such items must file all required licenses and/or certifications with the National Supplier Clearinghouse.

    CMS has established edits in the DME regional carrier claims processing system that will look for specialty codes 51, 52, 53, 55, 56, 57, 65, 67 and all physician specialty codes listed in the Medicare Claims Processing Manual, Chap. 26, Section 10.8.2 before reimbursing for such supplies. More details are in the Medlearn Matters article online at     www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3959.pdf.
     
  • Don't forget to check your new outcomes on the Home Health Compare Web site. The reconfigured patient outcomes list dropped four old measures and added three new ones (see Eli's HCW, Vol. XIV, No. 31). "Following a 2004 review of home health performance measures by the National Quality Forum ... CMS has made its first significant changes in HHC since November 2003," the agency says. The new data reflects outcomes from June 2004 through May 2005.
     
  • Regional home health intermediary Palmetto GBA has revised its Local Coverage Determin-ation (LCD) on occupational therapy for home health. Among other changes, Palmetto added two ICD-9 codes under "ICD-9 Codes That Support Medical Necessity" - 294.11 (Dementia in condition classified elsewhere with behavioral disturbance) and 331.0 (Alzheimer's Disease). Email rebeccaj@eliresearch.com for a copy of the LCD.
     
  • All home care workers in Illinois, including private duty, must undergo background checks starting Jan. 1. The National Private Duty Association cheers the newly signed law, which also will require promulgation of regulations for three different home care levels of service by 2008. As part of the check, workers' fingerprints will be submitted to the Illinois State Police and the FBI, reports the Herald & Review.
     
  • The Region B DMERC is opening its doors to suppliers. AdminaStar Federal is holding its fall open house on Sept. 20 in Indianapolis. For a fee, it will offer information sessions on topics such as documentation requirements, denials and mobility. More details are at www.adminastar.com/Providers/DMERC/Workshops/2005FallOpenHouse.html.

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