Home Health & Hospice Week

Enrollees will have to pay more for DME. A sharp increase in Medicare Part B premiums and deductibles is on its way in 2005 - the first increase in premiums since 1991.
 
Beneficiaries can expect premiums to rise by 17 percent next year, the Department of Health and Human Services announced Sept. 3. And three-fourths of that hike is attributable to additional Part B costs rung up under the Medicare Modernization Act.
 
Your patients can expect a monthly Part B premium increase of $11.60 to $78.20, up from $66.60 in 2004, HHS says.
 
For Medicare Part A, the deductible for 60 days of inpatient hospital coverage will be $912, up $36 from $876. Part B will increase to $110.
 
The premium and deductible increases coupled together were a "double whammy for America's 40 million Medicare beneficiaries," says Rep. Pete Stark (D-CA), ranking member on the House Ways and Means Health Subcommittee. Centers for Medicare & Medicaid Services Administrator Mark McClellan says the hike is part of creating an "enhanced Medicare."   Acute care hospitalization and emergent care utilization are two home health outcomes slated for special focus over the next three years. CMS has selected these two OASIS quality measures for Quality Improvement Organizations to work on in their next three-year contract cycle that started last month, according to the draft "8th QIO Scope of Work" for the QIOs.
 
At least 20 percent of HHAs also have to pick two other quality measures to focus on and meet or exceed the national target rate for those measures, the draft explains. The proposal is online at www.cms.hhs.gov/qio/2s.pdf.   Electrical stimulation and electromagnetic therapy for wound treatment do count toward M0825, a letter from CMS to the National Association for Home Care & Hospice confirms. "EM and ES must be provided by a physical therapist or a physician," CMS told NAHC in a recent letter. But the national coverage decision on the therapies "does not exclude the home as a setting where these services can be provided as long as all other criteria are met."
 
The treatment still must meet the rather stringent coverage criteria, CMS reminds providers (see Eli's HCW, Vol. XIII, No. 12, p. 92).   A claims remark code about parenteral pumps will get less confusing this month. Durable medical equipment regional carriers have been putting remark code M6 on claims for parenteral pumps. The message reads, "You must furnish and service this item for as long as the patient continues to need it. We can pay for maintenance and/or servicing for every 6 month period after the end of the 15th paid rental month or the end of the warranty period."
 
The problem is that Medicare actually covers maintenance and servicing every three [...]