Home Health & Hospice Week

Lone Star state sparks provider ID shuffle. If you needed proof the home health agency market is booming, look no further than the latest instructions from the Centers for Medicare & Medicaid Services.

"The State of Texas has run out of provider numbers for home health agencies," CMS says in May 7 Transmittal No. 80. Currently, HHA provider numbers use these series: 3100-3199, 7000-8499, and 9000-9499. Starting Oct. 4, CMS is adding 9500-9799 to the HHA series.

HHA branch ID numbers will see some changes as well. CMS is putting the letter "Q" in the third position between the state code and the four-digit provider designation, the transmittal indicates.

CMS will add three more digits at the end of the number branch ID number to consecutively identify each branch, up to 999. "In the event that an HHA branch closes, its unique branch identification number is terminated and will not be reused to identify another branch of that HHA or subunit," CMS explains. The Montana Medicaid program is not going to pay shipping costs for adult diapers, a decision from that state's highest court affirms.

Billings-based Juro's United Drug argued in county court that while Medicaid didn't pay for the company's direct delivery of diapers in the Billings area, it should pay shipping costs for the items for customers outside the area, according to the May 4 decision in Juro's United Drug v. Montana Dept. of Health and Human Services, (Mont., No. 03-075).

But the Medicaid program's prohibition on paying delivery fees applies both to provider travel costs and third-party shipping costs, the Montana Supreme Court said in the appeals decision. At issue was more than $10,000 in Juro's delivery costs from 1995 to 2000.

By paying unaudited claims with the delivery charges included, the Medicaid program didn't authorize reimbursement for the costs -- another of Juro's arguments, the court notes. Medicare is gathering data and crunching numbers on the Program of All-Inclusive Care for the Elderly. A range of data from patient surveys, site surveys, and claims and utilization data gathered at 12 PACE sites will help contractor Mathematica Policy Research Inc. evaluate quality and cost performance of the program, CMS says in a May 7 Federal Register notice. The PACE report is expected in 2006. Critical Home Care has acquired home care and staffing provider Arcadia Services Inc. and mail service pharmacy Arcadia Rx, the Westbury, NY-based home medical equipment company says. Critical had hinted at the transaction in April (see Eli's HCW, Vol. XIII, No. 12).

Southfield, MI-based Arcadia Services had $75 million in revenues in 2003 and has locations in 21 states. Arcadia Rx had revenues of $3 million in 2003, while Critical had $5 million in revenues for the fiscal year [...]