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Home Health & Hospice Week

Industry Notes:

MEDICARE CONTRACTORS TO EXPRESS PRO-HOSPICE SENTIMENTS

Published on Tue May 13, 2003

Physicians, nursing homes and hospitals soon will receive messages from their carriers and intermediaries extolling the virtues of the Medicare hospice benefit and assuring physicians not to worry about reprisals when certifying patients for hospice care.

The Centers for Medicare & Medicaid Services instructs contractors to publish an education article in their next bulletins, post it on their Web sites and send it out to the target audience via listserv, according to March 28 program memorandum AB-03-040.

The article "advises physicians that they need not be concerned about CMS penalties when certifying an individual for hospice care," the memo says. "There is no risk to a physician about certifying an individual for hospice care that he or she believes to be terminally ill," the article says.

The memo and the article are at www.cms.gov/manuals/pm_trans/AB03040.pdf.

  • HAVEN Version 6.1, which fixes some lingering bugs and adds several new features, is now available, CMS says. Home health agencies can download the latest version of the free OASIS software, and see a summary of the bugs fixed and features added, at http://www.cms.hhs.gov/oasis/havensof.asp.

    HAVEN 6.2 will be available Oct. 1 to accommodate the use of V codes, E codes and the new OASIS question MO245, a CMS spokesperson said at the OASIS Coordinators Conference in New Orleans April 1.

  • HHAs having trouble using their unwieldy OASIS patient tally reports can tap a new tool provided by CMS to mine the data in them for outcome-based quality improvement purposes. The Excel workbook, available at www.cms.hhs.gov/oasis/obqi.asp, should enable agencies "to focus on patients with specific attributes and outcomes and avoid manual review of lengthy printed reports," CMS says.

  • If suppliers submit their claims to the wrong durable medical equipment regional carrier for processing, the DMERC should forward the claim to the right carrier, CMS instructs in March 28 Transmittal No. 1791. But claims processing timeliness rules won't kick in until the proper DMERC receives the claim, the carrier manual addition says.

  • Orlando, FL-based Rotech Healthcare Inc. has big changes planned for 2003, from "headcount reduction" to exiting unprofitable business lines. "Considerable restructuring" is required for the company to be competitive, Rotech CEO Philip Carter warns of the company that emerged from parent Integrated Health Services' bankruptcy. The shake-ups will mean flat revenues for the near future, Carter predicts.

    Rotech already has made headway in its goal to maximize profitable oxygen business. Respiratory therapy equipment and services revenues increased 4.6 percent for the quarter ended Dec. 31, 2002 compared to the same period in the previous year, Rotech says. DME revenues declined 22 percent in the same time period, but the company "has initiated new efforts to rebuild its DME rental business," it promises.

    Rotech has reported net earnings of $2.1 million on revenues of $154.9 million for the quarter, compared to a $1.3 million profit on revenues of $156 million in 2001.

  • Almost Family Inc.'s visiting nurse unit revenues grew to $28.8 million in the quarter ended Dec. 31, 2002, compared to $27.9 million for the same period in 2001. The Louisville, KY-based adult day care and home nursing company has reported net income of $376,693 for the quarter, down from an $840,111 profit in the year-ago quarter.

  • Gentiva Health Services Inc. has acquired First Home Care-Houston Inc., a five-branch Medicare-certified home health agency in Texas with annual revenues of about $2 million.

  • Private pay home care provider Senior-Bridge Family has acquired San Antonio, TX-based home care and geriatric management firm Geriatric Services Inc., New York-based SeniorBridge says. The company purchased Geriatric Services from Gateway HomeCare Inc. for about $2 million, reports the San Antonio Business Journal.

    SeniorBridge plans to add six more offices to its existing nine locations in 2003, the company says.

  • Two top officials of Beavercreek, OH-based Pulmonary Analytic Laboratories Inc. face possible jail time and fines for illegally billing for in-home patient oximetry testing, says U.S. Attorney Gregory Lockhart. The company, CEO William Beekman and President Joseph McPartland all pleaded guilty to fraud charges March 21.

    Prosecutors say PAL officials ordered their staff to use billing codes for arterial blood gas tests, instead of those for oximetry tests, to evade Ohio Medicaid payment restrictions on in-home oxim-etry testing. They also told staffers to bill Medicare for 24-hour electrocardiographic monitoring tests that were never conducted.

    The company has agreed to pay nearly $750,000 to settle a civil claim brought by the Department of Justice. The company also faces up to $1 million in fines on the criminal charges; Beekman and McPartland face up to five years in prison.

  • A fight over hospice jurisdiction is raging in Maryland, with the state legislature square in the middle of the battle. A bill passed by the state Senate would restrict the operating area of nonprofit Maryland Community Hospice, part of a larger Washington, DC-based organization, Washington Home and Hospice. The hospice had received certificates of need to operate in 12 Maryland counties when it bought MedStar Health's hospice unit in 2001, reports The Baltimore Sun.

    Proponents of the bill claim the out-of-state hospice company, which uses a deceptively local-sounding name, is hurting smaller, county-specific hospice programs. But Maryland Community Hospice says restricting its service area will deprive many terminally ill patients of hospice services in those counties. The state House of Delegates held a hearing on the matter March 31 but has yet to vote on the legislation, reports The Washington Post.

     

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