Home Health & Hospice Week

Your visiting staff are likely feeling the pinch when they head to the gas pump. The average U.S. price for gas is $2.74 per gallon, according to the federal Energy InformationAdministration. That's still way less than when gas prices peaked at more than $4 per gallon in the summer of 2008, but nearly double the price this time last year.

As usual, the continental U.S. state where workers are paying the most for gas is California, where gas costs an average of $3.02 per gallon, according to Web site gasbuddy.com. The cheapest gas is available in Wyoming for $2.52 per gallon.

The higher prices at the pump may not translate into higher costs for your home health agency or hospice, however. That's because the Internal Revenue Service mileage reimbursement rate for 2010 is 50 cents per gallon, down from 55 cents per gallon in 2009. "The mileage rates for 2010 reflect generally lower transportation costs compared to a year ago," the IRS said in a release last month.

If you reimburse the IRS amount or have your rate tied to the IRS level, you'll see a reduction in costs. But at least for now, your workers will see higher travel costs, which may not be good for worker morale -- or retention rates.

On the other hand, if your mileage reimbursement rates are tied to actual gas prices, expect increased costs. (For tips on reducing mileage costs, see Eli's HCW, Vol. XVII, No. 23, p. 179).

• Home care providers are stepping up to help out after the devastating earthquake in Haiti. For example, Invacare Corp. is donating more than $100,000 worth of equipment and supplies, it says in a release. The items include 400 walkers, 100 mattresses, 250 canes, 640 pairs of crutches, 250 rollators, 175 wheelchairs, and hospital aids and supplies. The Elyria, Ohio-based manufacturer is partnering with MedWish International, a local Cleveland non-profit organization, to make the donations, Invacare says.

The Jersey Association of Medical Equipment Services is also coordinating donations from its members to go to Haiti, the trade group notes on its Web site. JAMES is working with the Coalition for Haitian American Empowerment of Monmouth and Ocean Counties to coordinate delivery of much needed items like gauze, bandages, and IV supplies, it says.

And the National Hospice Foundation has donated $15,000 to the relief efforts from its disaster relief fund, it says on its Web site. NHF, which is affiliated with the National Hospice and Palliative Care Organization, is giving $5,000 each to providers on the ground in Haiti -- Holy Angels Hospice, Partners in Health, and the Hôpital Albert Schweitzer (Albert Schweitzer Hospital).

"It feels good to know we are doing something tangible to help in the wake of such devastation," NHF's J. Donald Schumacher says. Individuals can donate at www.nationalhospicefoundation.org.

Home care providers should be sure to donate only to legitimate charities, cautions the National Association of Medical Equipment Suppliers. Scams abound after disasters.

• Yet another damning report from the HHS Office of Inspector General is making suppliers' lives harder. Medicare paid $4.4 million for "potentially inappropriate" pressure reducing support surface claims in 2007, the OIG says in its latest report.

Medicare paid 72 percent of support surface claims that used a GA or GZ modifier. Suppliers are supposed to bill with this modifier when they are furnishing an upgrade or don't expect the item to be considered reasonable and necessary, the OIG notes in the report at http://oig.hhs.gov/oei/reports/oei-02-07-00421.pdf.

Medicare also paid for more than one support surface per patient on the same service date, the OIG found. And the program paid for higher-priced support surfaces instead of lower-priced ones, it adds.

• You can now register for the new Home Health Quality Improvement national campaign. This year's campaign, which is sponsored by the Centers for Medicare & Medicaid Services and administered by Quality Improvement Organization West Virginia Medical Institute, will focus on reducing avoidable hospitalizations and improving oral medication management.

The campaign will aim to help home care providers establish partnerships with physicians, hospitals, and other provider groups, notes the National Association for Home Care & Hospice.

"By joining the home health national campaign, your agency will demonstrate its commitment to quality," WVMI says on the campaign Web site at www.homehealthquality.org. "You will also receive access to exclusive information and tools to help you continuously improve the care your agency provides." More than 5,500 HHAs participated in the last campaign, NAHC notes.

• You'll need to get used to a new look when you're searching for hospice benefit periods.

"The Common Working File (CWF) has changed the ELGA/ELGH screens that display the hospice benefit period information," regional home health intermediary Cahaba GBA says on its Web site. Under the change that took effect Jan. 4, "ELGA/ELGH displays any applicable hospice periods that have a termination date that is six months prior to the date entered in the 'APP DATE' field," Cahaba explains. "If no date is entered, the ELGA/ELGH displays hospice periods that have a termination date that is six months prior to the current date."

What that means for you: You'll have to enter a future date, within six months, when looking for current hospice benefit period information, Cahaba instructs.

For search examples including screen shots, see Cahaba's site at www.cahabagba.com/rhhi/news/20100112_elga.htm.

• With 2010 newly upon providers, CMS officials are stressing that 2013 isn't that far behind. And with 2013 comes a slew of new diagnosis codes.

"The transition date for ICD-10 codes is Oct. 1, 2013," said CMS's Stewart Streimer during a Dec. 16, 2009 CMS sponsored Open Door Forum for physicians. "That's really the drop-dead date."

"Many of the payers may even require ICD-10 codes before then so a sufficient amount of testing can take place," Streimer suggested.

Resource: To prepare, tap the CMS Web site for ICD-10 at www.cms.hhs.gov/icd10.

• If you aren't following the new claims data requirements for hospice that went into effect Jan. 1, don't expect to get paid.

Starting with the new year, Medicare now requires hospices to report visits in 15-minute increments by discipline (for details about visit reporting, see Eli's HCW, Vol. XVIII, No. 17, p. 132).

"Effective for claims with dates of service on or after January 1, 2010, Medicare contractors will return your claims that do not contain Revenue Codes 0655 and 0656, but DO contain one or more of visit revenue codes 042x, 043x, 044x, 055x, 056x, or 57x without the appropriate HCPCS code" RHHI Palmetto GBA warns on its Web site. "They will also return claims containing revenue code 0569 when billed without HCPCS code G0155."

For specific billing instructions, see Transmittal No. 1738 (CR 6440)online at www.cms.hhs.gov/Transmittals/downloads/R1738CP.pdf.

• Home health agency chain Amedisys Inc. has signed a national agreement with Humana Inc. to furnish home care services to their Medicare Advantage enrollees. The agreement covers 1.5 million participants in all 50 states.

The move will diversify Amedisys' revenue base beyond traditional Medicare, the Baton Rouge, La.-based company says in a release. It also "shows the importance of our expanded geographical footprint, which allows us to better support national insurance providers," Amedisys CEO Bill Borne says.

Humana expects home care services to "lead to better outcomes and fewer unnecessary hospital trips," the health plan says in the release.

• A tip from a Spokane, Wash. home health aide put a potential bomber behind bars, according to The Spokesman-Review newspaper. The unnamed home health aide became suspicious when her patient began researching bombs on the Internet and getting strange liquids in the mail. Bitter after a divorce, patient John D. Raymond alarmed the aide when he "mentioned ...that he could hide materials on his wheelchair and no one would notice," according to the search warrant.

The home health aide tipped off authorities, who later found the explosive TATP in Raymond's apartment. TATP "has been used by suicide bombers in Israel and was chosen as a detonator in 2001 by the thwarted 'shoe bomber' Richard Reid," according to CNN.