Home Health & Hospice Week

If you aren't sure whether your subsidiaries and new acquisitions are following the rules, now's the time to find out. Unfortunately, an Ohio home care agency is learning that lesson the hard way.

Viaquest Home Health has reached a settlement with the New Jersey Division of Consumer Affairs to stop placing uncertified home care aides with patients or employers who need help from a certified aide, according to the Asbury Park Press.

The agreement comes after an investigation into Viaquest Home Health LLC of Toms River. Viaquest made no admission of liability and admitted that it did not thoroughly examine the Toms River location when it was purchased in 2007, president and CEO Richard Johnson told the AAP.

Fallout: The state Attorney General did not monetarily penalize Viaquest for failing to follow the rules but did place new requirements on the company, which include:

• Verifying the license status of each health care practitioner prior to placement or referral;

• Verifying the practitioner's work history by confirming employment at all locations for the one-year period prior to placement or referral and not placing someone whose qualifications don't match the requirements of the patient or employer;

• Conducting an on-site in-home evaluation at least once every 60 days; and

• Conducting criminal background and history checks on all employees.

• Medicare and its beneficiaries could be getting gouged on standard power wheelchair costs. "Medicare and its beneficiaries paid almost four times the average amount paid by suppliers to acquire standard power wheelchairs during the first half of 2007," according to an August report from the Office of Inspector General.

For example, suppliers purchased standard power wheelchairs for an average of $1,048 and performed an average of five services in conjunction with supplying. However, because Medicare allows an average of $4,018 for those wheelchairs, Medicare and its beneficiaries paid suppliers an average of $2,970 beyond the suppliers' acquisition costs. That's a difference of 383 percent, the OIG pointed out in "Power Wheelchairs in the Medicare Program:

Supplier Acquisition Costs and Services." Based on its report, the OIG advised CMS to determine whether Medicare's power wheelchair fee schedule amounts should be adjusted by either using information from the competitive bidding program, seeking legislation that ensures fee schedule amounts reflect market changes, or by using its inherent reasonableness ability.

Response: CMS plans to use the information from the competitive bidding program and will consider new legislation to ensure fee schedule amounts respond to market changes but is unlikely to "use its inherent reasonableness authority until the results of the supplier bids for power wheelchairs under the Competitive Bidding Acquisition Program have been assessed," the OIG notes.

Read the report at www.oig.hhs.gov/oei/reports/oei-04-07-00400.pdf.

• Even if you just downloaded new home health PPS software, you have another new -- or, rather, old -- version to download.

CMS made a new grouper available July 16, noted CMS's Randy Throndset in the July 29 Open Door Forum for home care providers. However, agencies that downloaded the update need to head back over to the Pricer site and download another version -- one that reverts back to the previous version.

The revised grouper does contain provider data that's accurate as of August, CMS says.

• Rural agencies have a new option for diabetes training.  Effective Sept. 8, registered dieticians who are certified for diabetes education by a CMSapproved organization can now provide diabetes self-management training to patients in rural areas, according to an Aug. 7 transmittal.

CMS also announced that the American Association of Diabetes Educators is an accepted accreditation organization.

• If you rely on National Government Services, you'll want to bookmark a new site: NGS Medicare.com. The new site, called the Medical Policy Center, will serve as a central hub for all coverage policies and related information, including local coverage determinations, supplemental instructions articles, coverage articles, medical policy update articles, and contact information. The site, which went live Sept. 2, will combine  coverage information so that patients and agencies spend less time understanding NGS's policies.

• Political pundits are speaking out about the potential pitfalls health care reform could pose for home health agencies. While a health reform bill has yet to be adopted, the Obama "administration and Congress are already taking steps to ration cost-effective and life-saving programs such as home health care," claim Newt Gingrich, former House Speaker and founder of the Center for Health Transformation, and Nancy Desmond, the center's current president and CEO.

In its current form, the House's proposed reform bill includes $56.8 billion over 10 years in home care services cuts, they said in an op-ed piece in the Atlanta-Journal Constitution. "That's almost the entire federal budget for home health care services in 2007," Gingrich and Desmond say.

Their idea: Lawmakers should identify and stop "scam artists" rather than "gut home health care to fund a public health insurance system the majority of Americans don't want," they opine.

• The Joint Commission has a new way for you to cement your role as a leader in the industry: patient safety.

The group wants home care leaders to "step up efforts to prevent errors by taking the zero-defect approach used in other high-risk industries such as aviation and nuclear energy, according to its latest Sentinel Event Alert.

Reality: Administrators and clinical leaders set the tone and drive the culture in home care agencies. Therefore, those people are the ones who must shine a light on safety and make it an agency-wide priority, the alert pointed out.

The Commission outlined 14 specific steps that executive and senior level staff should follow if they want to improve patient safety.

Read the alert at www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_43.htm.