Home Health & Hospice Week

You may want to re-check your metropolitan statistical area designation to see if your wage index has gone up - or down. The Office of Management and Budget updates its MSA designations each decade, and the OMB announced its latest revisions June 6. Medicare uses wage index by MSA to set part of home health agencies' and hospices' payment rates. OMB designated 49 new MSAs and revised many of the other 321 areas. OMB says Medicare won't begin to use the new MSAs until fiscal year 2005, which begins Oct. 1, 2004. But it's unclear if the revisions will go into effect earlier than that. John Beard, President of Birmingham, AL-based Alacare Home Health and Hospice, expects to be able to use the revised MSA definitions immediately. Prospective payment system rules are clear "that when a HHA patient who starts services in a MSA relocates to a rural area (or vice versa) before the end of the episode, the HHA must bill using the code for the location the patient is in on the last day of the episode," Beard says. Alacare saw eight counties in its service area added to four different MSAs, and one county dropped from an MSA. A list of the new and revised MSA definitions is at www.whitehouse.gov/omb/bulletins/b03-04_attach.pdf. Your chances of being targeted for payback of alleged overpayments just went up - thanks to orders straight from the White House. Auditors now have more incentives than ever to identify - and collect - overpayments made to home care providers. In a May 8 memo from the White House Office of Management and Budget, released June 19, OMB Controller Linda Springer says state and local governments can now use a portion of recovered overpayments to pay for recovery contracts. That means when a state contracts with a firm to identify and collect overpayments in, say, the Medicaid program, the contractor can be allowed a percentage-based piece of the action - just as whistleblowers are under the False Claims Act. Former home care notable Robert "Jack" Mills died in a plane crash near Scotts-boro, AL June 19, reports the Associated Press. Mills, 64, was flying a six-passenger plane with his wife and two granddaughters aboard when it went down. The granddaughters survived, one with serious injuries. Jack and Margie Mills were convicted in 1996 of Medicare cost report fraud surrounding their home care company, First American Health Care of Georgia Inc., formerly ABC Home Health Services Inc. Many saw the investigation as the catalyst for the home care fraud-and-abuse witch hunt that occurred in the mid to late 1990s. Jack Mills was sentenced to more than seven years in prison and a $10 million fine for [...]