Home Health & Hospice Week

If you owe back taxes, the IRS can now come calling in non-traditional ways -- in fact, it might just garnish some of your Medicare reimbursement until you've paid back what you owe.

According to Centers for Medicare & Medicaid Services Transmittal 368, with an effective date of Oct. 1, businesses that owe tax money to the IRS may face levies.

"CMS may reduce federal payments subject to the levy by 15 percent, or the exact amount of the tax owed if it is less than 15 percent of the payment," the transmittal indicates. "The levy is continuous until the overdue taxes are paid in full, or other arrangements are made to satisfy the debt."

What this means to you: If you owe back taxes, the IRS will arrange to take 15 percent of your Medicare reimbursement until your levy has been satisfied, says attorney Michael Schaff with Wil-entz, Goldman and Spitzer in Woodbridge, N.J.

This means that you will continue collecting reimbursement, but the payment will be reduced by 15 percent until you no longer owe the IRS money.

Some providers will say, "I can't afford to pay these back taxes yet, I have to pay my ... staff first," suggests Randall Karpf with East Billing in East Hartford, Conn. "But the CMS transmittal confirms that the government will make that decision for you. Some [providers] may have to cut back on other expenses until their levies are paid off."

Medicare's signal: If the government has garnished part of your Medicare reimbursement, you'll see the code "WU" in the PLB03-1 data field, along with Medicare's phone number in case you have questions about the adjustment.

To read the complete CMS transmittal, visit the CMS Web site at http://www.cms.hhs.gov/transmittals/downloads/R367OTN.pdf. To review the related MLN Matters article, visit the CMS Web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6125.pdf.

• Keep your user IDs and passwords for accessing the NPI system safe, CMS reminds providers. You should review your National Provider Identifier information in the National Plan and Provider Enumeration System for accuracy once a year, CMS recommends. You should also reset your password annually.

You can access your NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do or access the NPI registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.

Don't forget: Medicare is now rejecting claims that contain legacy numbers, regional home health intermediary Palmetto GBA reminds providers in an email message.

But Medicare will allow you to put your own NPI in the referring provider field if you can't obtain the physician's number, CMS reiterates in Oct. 15 Transmittal No. 270 (CR 6093).

• If you've been thinking about starting up an outpatient therapy business to serve patients at home, you may want to check out Cahaba GBA's new Web site about the service.

"Outpatient therapy services may be furnished by a home health agency (HHA) to individuals who are not homebound or otherwise are not receiving services under a home health plan of care," the regional home health intermediary says on the new site. "These services are not paid under the Home Health Prospective Payment System (HH PPS). Instead, the home health agency's reimbursement for outpatient therapy services is calculated using the Medicare Physician's Fee Schedule."

The site, which includes instructions for submitting claims and requirements for claims data, is online at http://www.cahabagba.com/rhhi/claims/home_health/opt.htm.

• Clear up any confusion about how CMS sets payment amounts with a new resource from MedPAC. The Medicare Payment Advisory Com-mission has released its "Medicare Payment Basics" series, which discusses the specifics of payment rules for oxygen and oxygen equipment, home health, hospice, durable medical equipment, and other providers.

The HHA file, which could come in handy for educating referral sources, contains a chart overview of the clinical, functional, and service utilization domains under the prospective payment system. To access the documents that make up the series, visit the MedPAC Web site online at http://medpac.gov/payment_basics.cfm.

• HHA chains are banding together to prove the industry's worth to policymakers, legislators, and the public. Six companies including Amed-isys, LHC Group, and Gentiva Health Services have formed the new Alliance for Home Health Quality and Innovation.

"The home health industry offers a well-developed delivery system of high quality, lower cost health care services -- one of the most efficient and effective systems that exists in health care today," Bill Borne, AHHQI member and Amedisys CEO, says in a release. "The Alliance will demonstrate the readiness of the home health care industry to offer this delivery system as a key component in implementing new and innovative initiatives to meet the health care needs of our nation, particularly for America's seniors."

AHHQI plans to use research to educate the public and policymakers on the benefits that home health care can bring to chronic, acute, and prevention-based initiatives, the new group says.

"Home health's growing record of innovation and its potential to contribute lasting, positive changes to our national health system has led our industry and its more than one million employees to step forward so that their solutions and contributions receive the full recognition they deserve from policymakers and the general public," says AHHQI member and Gentiva CEO Ron Malone.

• HHAs that employ occupational therapists in certain states may have more hoops to jump through soon. That's because states that don't license OTs are becoming few and far between. Following close on the heels of Colorado passing a registration law for OTs last May, the Michigan state Senate passed a bill in September that would require OTs to be licensed. The vote was unanimous (35-0) for Senate Bill 921, according to an announcement on the American Occupational Therapy Association Web site.

The state House is currently considering the bill, which has the support of the Michigan Occu-pational Therapy Association.

• California HHAs served by National Government Services shouldn't be surprised when their Medicare payments start coming from somewhere new. On Nov. 4, NGS will transition banking activities from M&I Bank to JP Morgan Chase Bank on that date, the RHHI says on its Web site.

Those HHAs will have new lockbox addres-ses to submit checks to NGS as well, the intermediary adds.

Beware: "While we do not anticipate any delays in provider payments, please be aware the possibility exists and plan accordingly," NGS tells providers on the site.

• Revenues for Miami-based hospice chain VITAS increased nearly 9 percent to $205.0 million for the quarter ended Sept. 30. Net income for the for-profit business line was $17.6 million for the quarter, VITAS parent Chemed Corp. says.

Average daily census was 12,033 and average length of stay was 74.1 days in the quarter, Chemed says in a release.

Overall, Chemed saw earnings increase to $17.9 million in net income on $288.3 million in revenues for the quarter, compared to a $16.9 million profit on $272.5 million in revenues for the same period last year.

• Amedisys' revenues showed another huge jump over last year, thanks to its big TLC Health Care Services acquisition. Amedisys paid nearly $400 million for TLC earlier this year.

The Baton Rouge, La.-based national chain reported net income of $23.5 million on revenues of $321.6 million, it says in a release. That's compared to a $20.2 million profit on $180.9 million in revenues for the same period last year.

Those earnings figures include more than $1 million in TLC integration costs, Amedisys says. "All TLC agencies have been converted and are now operating on our corporate operating systems including the Point of Care network," CEO Bill Borne says in the release.