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Home Health & Hospice Week

Industry Notes:

Flu Vaccine Limitation Leaves HHAs High And Dry

Published on Thu Oct 07, 2004

Suspension of vaccine manufacturer's license halves U.S. supply.

If you expected to get your supply of flu vaccine from Chiron Corp., you may be out of luck.
 
First, Chiron said in August it found tainted doses of the vaccine in its England factory. Chiron planned to ship only about half of the nearly 100 million doses it expected to furnish this flu season, according to press reports. The discovery delayed those remaining shipments from September to October.
 
Then the United Kingdom's regulatory agency suspended Chiron's license to manufacture Fluvirin vaccine for three months, putting the remaining 46 to 48 million doses out of reach.
 
"The loss of the Chiron flu vaccine poses a serious challenge to our vaccine supply for the upcoming flu season," the Department of Health and Human Services says in a release. HHS is pursuing contingency plans to get hold of more vaccine from other sources, although it doesn't know "whether it's possible to get more vaccine," HHS acknowledges.
 
That leaves home health agencies like Northern California-based Sutter VNA with no idea whether they'll receive any flu vaccine to administer this season, reports The San Francisco Chronicle. "We are as shocked as everyone else," Sutter spokesperson Gerri Ginsburg told the paper. Sutter planned to give up to 100,000 vaccinations in Northern California.
 
HHAs that ordered FluMist nasal spray from MedImmune or vaccine from Aventis Pasteur Inc., the other main vaccine manufacturer, are on surer footing. But the Centers for Disease Control and Prevention urges that vaccinations go to priority populations first, including adults age 65 and older and persons with chronic medical conditions. The CDC recommendations are at www.cdc.gov/flu/.

 

  • You could furnish more insulin pumps under new Medicare coverage guidelines for the items. In previous national coverage decisions, the Centers for Medicare & Medicaid Services used C peptide testing as a requirement for covering subcutaneous insulin infusion, CMS explains in a draft decision memorandum. But in March Medtronic requested that CMS remove C peptide testing as a requirement for insulin pump coverage, and the American Association of Clinical Endocrinologists backed up the request.
     
    Commercial payors don't require the C peptide test. And when individuals switch over to Medicare, up to 25 percent of patients have to go off subcutaneous insulin infusion when they don't qualify under the test, Medtronic argued.
     
    CMS relented on the requirement, and now beneficiaries must either 1) meet an updated fasting C peptide test once or 2) be beta cell autoantibody positive, CMS says in the draft memo. Benes also must meet the other criteria for insulin pump coverage.
     
    More information is online at     www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=109.

     

  • Home care could be a feature of the new demonstration program to manage high-cost Medi-care beneficiaries.
     
    About 15 percent of beneficiaries account for 75 percent of Medicare spending, and CMS is looking for a way to control costs and improve quality of life for those patients. "This restructuring of care to integrate provider services and to deliver those services in locations such as the beneficiary's home could significantly improve their quality of life while also reducing costs for the beneficiary and Medicare," CMS says in a release.
     
    The Care Management for High-Cost Benefic-iaries demonstration will be the first project to focus on the high-cost fee-for-service population, CMS notes. Home care providers wishing to participate in the program must be part of a consortium including at least one physician group, hospital or integrated delivery system, CMS instructs. Participants must be willing to assume financial risk for the patients. More information is in the Oct. 6 Federal Register at     www.access.gpo.gov/su_docs/fedreg/a041006c.html.

     

  • Some home health agencies served by regional home health intermediary Associated Hospital Service have seen their accounts receivable suffer under AHS' new payment schedule. "Medicare Days Revenue in Receivables virtually doubled for some agencies when AHS reduced payments from bi-weekly to once a week," points out the Connecticut Association for Home Care.
     
    CAHC is working with other New England state associations "in seeking a solution to the cash flow crisis," it says in its member newsletter.

     

  • The Department of Health and Human Services has awarded $31 million in grants to 31 states to help individuals with disabilities stay in the community and out of institutions. "The grants ... help states and other eligible entities improve their home and community-based services programs," HHS says in a release.
     The New Freedom Initiative grants include funding for consumer-directed care programs, quality assurance and quality improvement, and a "rebalancing initiative ... to help states prevent and correct inappropriate placement of individuals in institutions."

     

  • You must say goodbye to your paper remittance advices if you also receive RAs electronically. For years CMS has required fiscal intermediaries to cease sending paper RAs if providers switch to receiving electronic RAs, says a new Medlearn Matters article. But CMS recently learned FIs haven't followed that requirement.
     
    By Jan. 1, FIs must cease sending the paper notices a month after providers switch to the electronic RAs, CMS instructed in a recent memo. CMS aims to achieve a "totally paperless claims processing and payment system," it says. More information is at     www.cms.hhs.gov/medlearn/matters/mmarticles/2004/SE0447.pdf.

     

  • It's never too early to start planning for next year. CMS has posted the OASIS Assessment Calendar tool on its Web site at www.cms.hhs.gov/oasis/hhnew.asp. The pdf tool helps agencies correctly schedule OASIS recertification assessments in the last five days of the 120-day episode by listing recert windows for three subsequent recerts.

     

  • Add two more notches to Amedisys Inc.'s acquisition belt. The Baton Rouge, LA-based regional chain has purchased two HHAs from Georgetown, SC-based Winyah Health Care Group for undisclosed terms. The agencies are in Augusta, GA and Clinton, SC.
     
    Amedisys expects the Augusta agency to contribute $1.75 million in revenues next year. The acquisition "enables us to continue expanding our service offering throughout the Southeast United States," Amedisys CEO Bill Borne says in a release. The company continues to consider further deals.

     

  • Clark's Home Medical Products Group will operate out of two new Dayton, OH locations, reports the Dayton Business Journal. The business operates in Clark's Mr. Prescription pharmacy stores, a local Dayton chain now with nine locations. The HME business generated more than $1 million in sales last year, the paper says.

     

  • Now is the time to give the government your two cents on accreditation by the Joint Commission on Accreditation of Healthcare Organizations and the Community Health Accreditation Program. Oakbrook Terrace, IL-based JCAHO and New York City-based CHAP have applied to renew their "deemed" accreditation statuses, which allow home care providers accredited by the organizations to be exempt from state surveys. In the Sept. 24 Federal Register, CMS calls for comments on the applications and the process in general. Those comments are due Oct. 25.

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