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Home Health & Hospice Week

Industry Notes:

Home Care Now, Prescription Drugs Later

Published on Fri Jul 25, 2003

Lawmakers start ironing out differences in House, Senate Medicare bills.

Despite a long road ahead on debate of the Medicare prescription drug bill, lawmakers could wrap up their deliberations on the bill's home care provisions quicker than providers would like.

President Bush has called off his July deadline for the Medicare bill to reach his desk, and observers expect debate on it to reach into the fall. But legislators have signaled a desire to iron out the provider payment and regulatory reform differences in the House and Senate bills before Congress' August recess.

The House appointed its representatives to the conference committee that is in charge of producing a unified bill for the House and Senate, and the committee first met July 15.

Home health agencies want to stave off, among other things, a copayment and reductions to inflation updates. Durable medical equipment suppliers oppose competitive bidding and other unfavorable provisions.

  • Your patient outcome data may mean more than just OBQI reports to brag about. The Centers for Medicare & Medicaid Services has announced a pilot project that would financially reward hospitals for high patient quality data and punish them for low data, and the same paradigm could be used for HHAs.

    Under the three-year pilot, hospitals that perform in the top 10 percent would collect a 2 percent bonus on their Medicare payments; those in the second 10 percent would get a 1 percent bonus. But during the third and final year, participating hospitals that fail to meet a certain benchmark could face a 1 to 2 percent cut in their Medicare payments.

  • Another home care financier could be going down the tubes. All three bond rating services - Standard & Poor's, Fitch Ratings and Moody's Investors Service - have downgraded their ratings of DVI Inc.'s bonds after Deloitte & Touche stepped down as the company's auditor over DVI's financial practices.

    Jamison, PA-based DVI, an asset-based lender to the health care industry, failed to file an audited report with the Securities and Exchange Commission for the quarter ended March 31. The company has hired UBS Securities Inc. to help it raise additional capital or even sell the company, DVI says.

    The situation echoes the meltdown of another asset-based lender, National Century Financial Enterprises, which put a number of home care providers into bankruptcy.

  • If you're still grappling with HIPAA compliance, you can take advantage of a free HIPAA conference call offered by CMS July 31 from 2 to 3 p.m. ET. Dial in 15 minutes ahead of time to 1-877-381-6315 with conference identification number 1596405.

  • Medicaid fraud control units nationwide netted a total of $288 million in restitution, fines, penalties and settlements in fiscal year 2002 - up from $252.5 million in 2001, says an HHS Office of Inspector General report on MFCUs released July 9. But convictions in fraud cases skyrocketed from 1,002 in 2001 to 1,452 last year - showing that states are willing to get tough when it comes to purported Medicaid fraud.

  • The Joint Commission on Accreditation for Healthcare Organizations wants your two cents on its newly revised infection control standards. Feedback on the standards, available at www.jcaho.org, is due by Aug. 1.

    Full implementation of the standards is scheduled for January 2005, the Oakbrook Terrace, IL-based accrediting body says.

  • Medicare reimbursement for flu and pneumococcal vaccinations changed as of July 1, the National Association for Home Care & Hospice reminds HHAs. Intermediaries will reimburse agencies on a cost basis for their vaccinations. "The methodology is similar to that used to pay home health agencies for medical supplies under the old cost-based system," NAHC says in a recent bulletin.

  • Regional home health intermediary United Government Services has received a mostly clean bill of health on its administrative costs from the OIG. UGS' internal controls "were generally adequate," and the OIG accepted $196.7 million of the $197 million in administrative costs claimed from Oct. 1, 1998 to Sept. 30, 2001, according to a recent OIG report (A-05-02-00047).

    The OIG did recommend financial adjustments of more than $260,000 for "excessive executive compensation increases, unallocable guarantee fees, and overcharged corporate overhead," however. The report is at http://oig.hhs.gov/oas/reports/region5/50200047.pdf.

  • Specialized Home Medical Services Inc. has acquired Alert Medical Inc.'s ventilator division for an undisclosed sum, the Boca Raton, FL-based durable medical equipment company says. "This acquisition will be only the first of many which will increase our services and patient base," Specialized says in a release.

  • Matria Healthcare Inc.'s subsidiary, Quality Oncology Inc., has signed an agreement with Great-West Life & Annuity Insurance Company for QO to furnish comprehensive disease management services nationwide for beneficiaries with cancer, the Marietta, GA-based DM company says.

    The program will be available to all of Great-West's two million members by the end of the year, according to Matria.

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