Home Health & Hospice Week

You'll have to get your referring docs' NPIs straight by May.

In the hubbub over PPS refinements and OASIS changes, don't forget one major billing requirement in the new year--including National Provider Identifier numbers on your claims.

All Medicare Administrative Contractors (MACs) already are rejecting claims if they can't validate NPIs used in NPI/legacy number pairs against the NPI crosswalk, the Centers for Medicare & Medicaid Services says in an email message to providers. Durable medical equipment MACs began rejecting such claims Oct. 29.

Starting Jan. 1, contractors will also reject claims without an NPI in the primary provider fields, CMS reminds. Those are the billing and pay-to fields.

New deadline: For the time being, providers still will be able to use legacy-only numbers in secondary fields, such as the one for referring physicians. However, by May 23, providers will have to use NPIs in those fields as well, CMS reveals.

More NPI information is online at www.cms.hhs.gov/NationalProvIdentStand.

• Legislators continue to wrangle over Medicare provisions. Senate Finance Committee ranking member Charles Grassley (R-IA) wants a smaller, one-year fix for physician payments, according to press reports. That would leave lawmakers looking for less funding to cover the fix, which could let home care providers off the hook for payment cuts.

But committee Republicans also are resisting using cuts to Medicare Advantage plans to pay for the elimination of the 10 percent doc cut. That could put home care providers--including home health agencies, oxygen providers, wheelchair suppliers and others--back on the budget chopping block, observers warn.

• Home care providers have stepped up to the plate to help during the recent wildfires in Southern California. Apria Healthcare saw 20,000 of its patients displaced by the fires or facing extreme smoke conditions, reports the American Association for Homecare.

Apria employees staffed disaster shelters, conducted patient inquiry calls and delivered oxygen and medical equipment directly to homes, said Steve Foreman, Apria's regional VP of operations for Southern California. The Lake Forest, CA-based company also helped a nursing home evacuate its patients by furnishing 45 beds for transfer, AAHomecare says.

San Diego-based SeQual Technologies provided emergency responders with 40 portable oxygen systems for distribution at Qualcomm Stadium in San Diego, the company tells the trade group.

• If you're interested in the imminent pay for performance demonstration, tune into CMS' special Open Door Forum on the P4P demo. The Nov. 13 forum will include a question-and-answer session for those eligible to participate.

Enrollment deadline: The seven-state demonstration will stop accepting enrollment Nov. 30, CMS says. For more demo details, see Eli's HCW, Vol. XVI, No. 37, p 282. CMS' P4P demonstration Web site is www.hhp4p.info.

Plan ahead: You must register by Nov. 9 to participate in the forum, CMS instructs. The registration site is at http://registration.intercall.com/go/cms2.

• The feds are reminding home medical equipment suppliers that they're studying the impact of competitive bidding on beneficiaries. Abt Associates has contracted with CMS to conduct the research.

"A survey among a sample of DMEPOS suppliers is now under way," says CMS in an announcement about the study.

If you're received a copy of the survey, take note: The survey is voluntary, but CMS advises that "success depends on having each sample member complete the questionnaire in order to maximize the reliability of information collected."

• Regional chain Amedisys Inc. predicts the PPS refinements will have a relatively minor effect on its revenues. After extensive modeling, the Baton Rouge, LA-based company projects a 1 percent reduction to its 2008 Medicare revenues due to the changes taking effect Jan. 1.

Amedisys had another banner quarter, reporting net income of $20.2 million on revenues of $180.9 million for the quarter ended Sept. 30, as compared to a $10.6 million profit on $137.0 million in revenues for the same period in 2006.

The company has 311 HHAs and 27 hospices, it says in a release. Amedisys made 1.1 million visits in the quarter.

• Hospice chain Odyssey Healthcare Inc. saw revenues increase but profits decrease in the latest quarter. The Dallas-based for-profit reported net income of $3.6 million on revenues of $104.3 million for the quarter ended Sept. 30, compared to a $5.6 million profit on $100.2 million in revenues for the same period in 2006.

The company's Medicare cap allowance negatively impacted income, Odyssey says in a release.

• Concerns about the coming PPS refinements may be chilling the mergers and acquisitions market for home health agencies. HHA deals in the third quarter of 2007 are down about 28 percent over last year, reports M&A firm The Braff Group.

Interest among potential buyers remains high, however, maintains Pittsburgh-based Braff. And overall HHA deal numbers for the year remain about even with 2006.