Home Health & Hospice Week

It just may have become more difficult to get negative home care provisions out of - and good home care provisions into - the pending legislation for a Medicare prescription drug bill and other Medicare changes. The Congressional Budget Office says both the House and Senate-passed bills are over the $400 billion, 10-year limit set by President Bush and approved by Congress in the fiscal year 2004 budget. And they're over by tens of billions of dollars. The shortfall may mean legislators will look for cuts to support drug benefit provisions, and home care makes an appealing target. Home health agencies are fighting to get copayments and reductions to payment updates out of the bill while making sure that an add-on for rural home health services and homebound demonstration projects stay in. Durable medical equipment suppliers want to avoid national competitive bidding for a number of items. It now appears that the committee working to reconcile the House and Senate Medicare bills won't reach agreement on provider-specific provisions until after the August recess, when it also will tackle the prescription drug specifics. Agreement on certain regulatory provisions might occur before the end of the month, however, observers say. Medicare beneficiaries aren't limited to the blood glucose testing strip parameters the Centers for Medicare & Medicaid Services set in a 2002 program memorandum, but suppliers should expect to have to furnish documentation justifying the need for additional strips above that limit, CMS said in the June 25 special Open Door Forum for DME. In most cases, 100 strips in a three-month period for non-insulin treated beneficiaries, and 100 strips in one month for insulin-treated benes is reasonable and necessary, a CMS official said. But some patients need to test more often, and Medicare will pay for supplies when they do, CMS promised. However, suppliers shouldn't be surprised if the DME regional carriers ask them to show justification for the increased testing need. Software vendors and HHAs that write their own OASIS software can call into an Aug. 20 teleconference put on by CMS. It aims to help vendors and agencies better understand the requirements and specifications for the new version of OASIS that takes effect in October. The technical teleconference, which will go over OASIS Version 1.40, will be from 1 p.m. to 2:30 p.m. ET. More information is at www.cms.hhs.gov/oasis/82003svt.pdf. HHAs shouldn't hold their breath waiting for the new conditions of participation. The home health COPs, which have been repeatedly delayed for years, are now slated for "early 2004," a CMS source said in the July 3 Home Health Open Door Forum. The last due date from CMS had been December 2003. CMS is adding and revising some HCPCS codes [...]