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Home Health & Hospice Week

Industry Notes:

Medicare Contractor Customer Service Aims To Improve

Published on Thu Sep 30, 2004

Scathing GAO report produces results - but will they make a difference?

Get ready for an about face from your Medicare contractor's customer service center. You can now expect concrete improvements under a new customer-service program that's slated to begin Jan. 1.
 
A scathing August report by the Government Accountability Office (GAO-04-669) said that after performing hundreds of test calls to 34 contractor call centers, only 4 percent of the responses received were correct and complete.
 
Here are the changes you can expect:

* Provider self-service technology tools: With these changes, you'll get interactive voice response units for telephone inquiries, improved Web site options, and electronic copies of provider bulletins that the Centers for Medicare & Medicaid Services will publish and post quarterly.

* Provider contact center improvements: CMS promises an inquiry tracking and triage process, as well as better staffing and training of customer service reps.

* Provider outreach and education: This includes training tailored for small providers, "ask-the-contractor" teleconferences (ACT), and initiatives aimed at reducing the claims error rate.
 

  • Two Southern states are grappling with their home care needs.

    Tennessee is finally taking applicants for the state's home care waiver program approved in October 2003. The state is offering 2,700 slots in the program that furnishes homemaker services, personal-care services, minor home modifications, personal emergency response systems, home-delivered meals, case management and limited institutional respite care, on a first-come, first-served basis, reports the Knoxville News-Sentinel.
     
    But the program has some steep requirements. Besides being Medicaid-eligible, participants in the program must have a caregiver in the home 24 hours a day and must see a physician every 60 days.
     
    Tennessee ranks 49th in the nation on home care versus nursing home spending, the paper says. The program originally had trouble finding nursing homes that would agree to furnish the inpatient respite care the program requires.
     
    Meanwhile, South Carolina residents face lengthy waiting lists to access Medicaid home care benefits. About 3,000 elderly residents are waiting for home care services, The (Columbia, SC) State reports. That's down from a list of 4,000 in 1997 but only 1,100 in 1999.
     
    Another 1,700 severely disabled residents are on a waiting list for home care services - up from 970 waiting last year, the paper says.
     
    State officials worry they will be sued under the Supreme Court's 1999 Olmstead decision requiring care in the community, they say.     
     
  • CMS' proposed regulation requiring physicians to examine home medical equipment users face to face before prescribing HME is riddled with problems, the Power Mobility Coalition says in comments on the rule (see Eli's HCW, Vol. XIII, No. 30, p. 235). PMC targets problems with the suggested timeline; the requirement that the practitioner visit cannot be for the sole purpose of obtaining durable medical equipment; the unclear documentation requirement; and the lack of any special consideration for "homebound" beneficiaries.
     
  • You may see some business come your way from Medicare PPOs. The PPO managed care demonstration was not good for home health agencies - or beneficiaries, says a recent report from the Government Accountability Office, "Financial and Other Advantages for Plans, Few Advantages for Beneficiar-ies" (GAO-04-960). CMS exceeded its authority when it allowed 29 of the 33 demo health plans to not cover certain services, including home health care, if beneficiaries received them from out-of-network providers.
     
    CMS should "promptly instruct plans in the Medicare PPO Demonstration to provide coverage for all plan services" furnished by any Medicare provider "who accepts the plans' terms and conditions of payment," the GAO urges. CMS says it will implement the recommendation.     
     
  • Reps. Greg Walden (R-OR) and Earl Pomeroy (D-ND) are gathering support to extend for another two years the 5 percent payment add-on rural HHAs currently receive. The add-on is set to expire in March 2005. The congressmen sent out a "Dear Colleague" letter urging lawmakers to sign on to H.R. 4902, the bill introduced in July that calls for the extension (see Eli's HCW, Vol. XIII, No. 27, p. 215). The bill currently has 32 cosponsors, the letter notes.

    "If the extra rural payment is not extended, agencies may be forced to turn away rural patients with the greatest care needs," the letter says. Sen. Susan Collins (R-ME) introduced the same legislation in the Senate in July (see Eli's HCW, Vol. XIII, No. 26, p. 205).
     
    Although experts don't expect Medicare legislation to pass in this election year, garnering support for H.R. 4902 now is critical for passage next year, they say.     
     
  • Chartwell Diversified Services Inc. has shaken off the yoke of bankruptcy and its failed parent, Med Diversified Inc. Addison, TX-based Chartwell completed its Chapter 11 reorganization process and emerged as a privately held company Sept. 17, it says.
     
    Chartwell has secured financing with Healthcare Business Credit Corporation "to meet its short-term and long-term goals," the company says. Med will liquidate after it completes the sale of Tender Loving Care Health Services Inc. to Crescent Capital Investments Inc. (see Eli's HCW, Vol. XIII, No. 15, p. 115). Crescent won a bid to buy TLC with an offer topping $188 million, but the changeover isn't expected to take place until the end of the year.     
     
  • Critical Home Care Inc. has purchased North Carolina-based DME company Trinity Healthcare, the Southfield, MI-based home care company says. Trinity furnishes oxygen and respiratory services from locations in Winston Salem and Huntersville, NC, and Marietta and Demorest, GA. Trinity employs 50 people, who will stay on as Critical employees.
     
    "The purchase provides us with a growing presence in the durable medical equipment marketplace," CEO John Elliott II says in a release. Critical has made four acquisitions in the last few months, two of them involving respiratory DME companies. 
     
  • VITAS Healthcare Corp., now going by the name VITAS Innovative Hospice Care, has opened a start-up office in Newark, DE. The Delaware operation is VITAS' 31st program in 11 states. 
     
  • Jordan Hospital in Plymouth, MA is getting ready to shed its home health and hospice programs, reports The (Quincy, MA) Patriot Ledger. Cura VNA & Cranberry Hospice has suffered significant financial losses in recent years, Jordan Health System officials told the paper. Currently Jordan is "evaluating options for improving the financial position" of the agency, the Ledger says.

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