Home Health & Hospice Week

You might not have as many Health Insurance Portability and Accountability Act business associate agreements to pull together as you thought. The Centers for Medicare & Medicaid Services lays out the ground rules for fiscal intermediaries and carriers as far as dealing with the business associate provisions of the HIPAA privacy standards in May 23 program memorandum AB-03-078. In a nutshell, FIs and carriers are business associates of Medicare itself - not of individual health care providers. CMS orders FIs and carriers not to sign business associate agreements with providers unless "the provider, physician, supplier or other health plan is doing work on behalf of the Medicare contractor." The memo is at www.cms.hhs.gov/manuals/pm_trans/AB03078.pdf. The Senate Finance Committee was poised at press time to vote on its Medicare reform package, which included a seven-year payment freeze for durable medical equipment, an increase to the Part B deductible and a rural add-on for home health agencies. The House is still working on its version of the Medicare reform bill, which adds a prescription drug benefit to the program. A new supplement to the OBQI manual explains the new three-bar outcome reports and three-column case mix reports under the outcome-based quality improvement measure. "The pdf file contains a brief narrative followed by an appendix with illustrative reports and a second appendix with the 'how-to read' guidelines," CMS says on its OASIS Web site at www.cms.hhs.gov/oasis/obqi.asp#supp. Home health agencies should print up the supplement and add it to their existing OBQI manuals, CMS urges. HHAs in Connecticut and Massachusetts may be in line for a paperwork break when it comes to dual eligible beneficiaries. CMS plans a new demonstration project that uses sampling to determine the Medicare share of home health claims for services provided to dual eligibles and paid for by Medicaid, according to May 30 program mem-orandum A-03-046. The process will replace the cumbersome assembly of Medicare documentation from agencies for all dual-eligible claims the state may have paid erroneously. "This process will eliminate the need for the HHAs to assemble, copy, and submit large numbers of medical records," the memo says. Florida will implement a much wider consumer-directed care program for Medicaid home care services, the Department of Health and Human Services says in a release. The state piloted consumer-directed care in the national "Cash and Counseling" demonstration project, and now expects more than 2,000 beneficiaries to use the expanded program. "Consumers and their families will be involved in planning all aspects of service delivery, including but not limited to the hiring, direction and appraisal of service providers," HHS explains. "A 'support broker' and a financial management service will assist" with the process, including payroll. Indiana plans to hire [...]