Home Health & Hospice Week

Medicare cuts still up in the air.

Home care providers may soon get an idea of what House members have in mind for them next year.

The House Budget Committee March 29 passed its fiscal year 2007 budget resolution, which is the blueprint for later binding budget legislation. As the industry hoped, the committee followed the Senate's lead and didn't include any Medicare or Medicaid cuts in its resolution (see Eli's HCW, Vol. XV, No. 11).

But a battle between conservative and moderate Republicans may end up with the full House approving Medicare cuts in the final resolution legislation.

It could be a while before home care providers find out for sure what's in store. In this election year, lawmakers may finish up their 2007 budget legislation before the session ends in October. Or they may come back to vote on final budget legislation in a lame duck session after elections, observers predict.

• Durable medical equipment suppliers are bracing themselves for a big hit from Medicare starting this month.

Beginning April 1, DME suppliers with Medicare claims have to bill non-invasive positive pressure ventilators as capped rental items. For large suppliers, the annual impact of the reimbursement change could be a revenue drain measuring in the millions, according to American Homepatient Inc., a supplier based in Brentwood, TN.

The Centers for Medicare & Medicaid Services is allowing a transition period for devices that beneficiaries are currently renting, so that rental months paid prior to April 1 will not count toward the 13-month rental cap (see Eli's HCW, Vol. XV, No. 5).

• Public Citizen has filed suit against the Deficit Reduction Act in U.S. District Court for the District of Columbia, the consumer advocacy group says in a release. Like an earlier suit filed by Alabama attorney Jim Zeigler, the suit says the DRA is invalid because the House and Senate passed different versions of the law (see Eli's HCW, Vol. XV, No. 9).

"The entire law is invalid because the law the House passed is different from the law the Senate passed and the President signed," Public Citizen attorney Adina Rosenbaum says in the release. The discrepancy regards a clerical error over the capped rental period for home medical equipment.

• If you have patients that stay in different places throughout the episode, you should use the wage index applicable on the last date of service, regional home health intermediary Palmetto GBA says in a recent set of questions and answers on its Web site. That applies to a hospice patient who stays with different family members in different CBSAs throughout the month, Palmetto advises.

• Just when you've gotten used to CMS' Medlearn Matters provider education articles, it's time to learn a new name. CMS will now call its education articles "MLN Matters" articles, which stands for Medicare Learning Network, CMS says in a new MLN Matters article at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0620.pdf.

• Your referring physicians who aren't up on the latest federal directive on power mobility device claims are risking nonpayment.

On March 24, CMS issued a revised MLN Matters (formerly Medlearn Matters) article on the topic, stressing that docs submitting claims on or after April 1 must bill the E/M and the G0372 code on the same claim. CMS established a separate add-on payment to the office visit, billed with the code of G0372, "to recognize the additional physician work and resources required for submitting pertinent parts of the medical record" for PMD coverage, the agency notes in the article (see Eli's HCW, Vol. XV, No. 7).

For details, go to www.cms.hhs.gov/MLNMattersArticles/downloads/MM4372.pdf.

• National Home Health Care Corp. saw earnings increase for the quarter ended Jan. 31. The Scarsdale, NY-based regional provider reported net income of $891,000 on revenues of $25.7 million for the quarter, compared to a $796,000 profit on $24.2 million in revenues for the same period the previous year. NHHC attributes the increase to a New Jersey acquisition and expanded business in Massachusetts and New York.

• A Volunteer State home care provider has made the HHS Office of Inspector General's hit list. A former Tennessee Medicare and private duty HHA owner was sentenced to 24 months in prison and ordered to pay $700 for health care fraud and false statements, the OIG says in its latest enforcement action examples.

The owner failed to disclose the private duty agency as a related party on cost reports for years 1998 to 2000 and shifted the private duty costs to Medicare on the reports, the OIG says. The owner will also have to pay a yet-undecided amount of restitution.