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Home Health & Hospice Week

Industry Notes:

Feds Tap HHA For Chronic Disease Management Project

Published on Thu Dec 09, 2004

10 CCIP providers named for DM project's pilot phase.

Home care will have a place at the table in Medicare's new disease management program.
 
One of the recipients of CMS' Voluntary Chronic Care Improvement Program awards is the Visiting Nurse Service of New York. In partnership with United HealthCare Services Inc.-Evercare, VNS-NY will offer DM services to chronically ill beneficiaries in Queens and Brooklyn in New York City, CMS says.
 
Under the CCIP pilot phase, organizations will offer DM services to fee-for-service beneficiaries with chronic conditions including congestive heart failure, complex diabetes, and chronic obstructive pulmonary disease.
 
The self-care and support programs "are intended to help increase adherence to evidence-based care, reduce unnecessary hospital stays and emergency room visits, and help participants avoid costly and debilitating complications," CMS notes. Bene participation is voluntary.
 
Other program winners are Aetna Health Management in Chicago; American Healthways Inc. in the District of Columbia and Maryland; CIGNA HealthCare in Georgia; Health Dialog Services Corp. in Pennsylvania; Humana Inc. in Central Florida; LifeMasters Supported SelfCare Inc. in Oklahoma; McKesson Health Solutions in Mississippi; and XLHealth in Tennessee.
 
More information about the CCIP pilot project, which aims to serve 150,000 to 300,000 beneficiaries, is at www.cms.hhs.gov/medicarereform/ccip/. The first program is expected to launch this spring.

 

  • Opponents of certificate of need rules, which allow states to limit the number of home care providers, may be happy to see an antitrust probe into the CON practice in Vermont. The U.S. Department of Justice requested information from some of the 12 HHAs operating in Vermont last month, the Associated Press reports. The Federal Trade Commission is involved in the investigation as well, notes the National Association for Home Care & Hospice.
     
    The Vermont HHAs say they've done nothing wrong and are only operating under a state-supervised system. It appears a complaint triggered the investigation, NAHC reports. The probe seems to be focusing on HHAs using their Medicare-dominant position to secure non-Medicare business, the association adds.

     

  • Don't forget to check our your new Home Health Compare scores at www.medicare.gov. CMS updated the data Dec. 2, it says.

     

  • Health and Human Services Secretary Tommy Thompson, who has served in the position since 2000, announced his resignation Dec. 3. And CMS could be next to see its top spot emptied.
     
    At a news conference, Thompson said he had initially wanted to resign shortly after the Medicare Modernization Act was enacted at the beginning of this year. But the White House persuaded him to serve out the rest of President Bush's first term, he said.
     
    CMS Administrator Mark McClellan is a top contender to take the helm at HHS. However, losing its second administrator in less than a year could be a heavy drain on CMS, which has yet to complete implementation of the MMA. Thompson will continue in office until Feb. 4, or until a new secretary is confirmed.

     

  • A little more flu vaccine will be making its way into the U.S. system. The Food and Drug Administration has authorized the use of a Glaxo SmithKline influenza vaccine, Fluarix, under an Investigational New Drug application, HHS says. The agency has reached an agreement with the company to purchase 1.2 million doses of the vaccine. The Centers for Disease Control and Prevention (CDC) will distribute the vaccine to communities most in need, HHS says.

     

  • For-profit hospice chain VistaCare Inc. reported a loss and sagging revenues for the quarter ended Sept. 30. After taking a $7.8 million charge for Medicare cap overages, the Scottsdale, AZ-based company announced a $6.2 million loss on revenues of $48.7 million, compared to a $3.8 million profit on $50.0 million in revenues for the same period in 2003.
     
    Admissions were down in the quarter compared to the same period in 2003, but the company notes they increased again in October and November.

     
  • The instructions on billing hospice physician consultations have hit the books (see Eli's HCW, Vol. XIII, No. 40, p. 316). In Dec. 3 Change Request 3585, CMS notes the national payment amount for G0337 will be $54.57.
     
    Hospices must bill their regional home health intermediaries (RHHIs) directly using HCPCS G0337 with Revenue Code 0657. "No other revenue codes may appear on the claim," CMS stresses.
     
    And Medicare will pay for the service only once, so duplicate G0337 claims will be denied. The National Association for Home Care & Hospice protests that hospices have no way of knowing whether a beneficiary has received the service before. More information is at     www.cms.hhs.gov/manuals/pm_trans/R28BP.pdf.

     

  • Amedisys Inc. has acquired a Winston-Salem, NC HHA for undisclosed terms, the Baton Rouge, LA-based chain says. Amedisys gained a seven-county certificate of need in the transaction, the company notes. The acquired agency, which was owned by nursing homes, is expected to contribute $1 million in annual revenues. 

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