Home Health & Hospice Week

Get ready for more paperwork headaches under a dual number system for surveys.

Think the National Provider Identifier numbers required in May will simplify your Medicare paperwork? Think again.

After the NPI implementation, the Centers for Medicare & Medicaid Services will continue to issue and use Medicare/Medicaid Provider Numbers, CMS says in a March 2 memo to state survey agencies (S&C-07-16).

New name: To decrease confusion between the new numbers, CMS will call the Medicare Provider Number the "Centers for Medicare & Medicaid Services Certification Number" or CCN.

HIPAA requires providers to use NPIs on all HIPAA-regulated transactions, such as claims, by May 23. But CMS will use the new CCN on all Survey and Certification and patient assessment transactions, the memo specifies.

"In some activities, both numbers will be used," CMS says. The memo is online at www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter07-16.pdf.

• Home care providers could soon face big changes in the way aides and other staffers can unionize.

On March 1, the U.S. House of Representatives passed the "Employee Free Choice Act" (HR 800). The legislation would fundamentally alter the balance of labor relations in the United States to favor unions.

The vote was 241 members in favor of the bill and 185 opposing. Thirteen Republican representatives voted with the overwhelmingly Democratic majority, according to the Associated Press.

Identical legislation is expected to be proposed by Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-MA) soon.

• Durable medical equipment suppliers and others will have a little longer to migrate to the new CMS-1500 claim form. CMS originally said it would accept the old 1500 form (12-90) until April 1. Now because of formatting problems with form vendor Government Printing Office, CMS has extended that date to June 1, it says. After that, suppliers will have to use the new 1500 form (08-05).

Carriers will accept both forms in this transitional period. But CMS will direct contractors to return, not manually key, any CMS-1500 (08-05) forms received that aren't formatted correctly. "By returning the incorrectly formatted claim forms back to you, we are able to make you aware of the situation which will allow you to begin communications with your form supplier," CMS says.

• You could see more scrutiny on your drug coverage for dually eligible hospice patients. Oklahoma's Medicaid program incorrectly paid $3,680 for prescriptions that Valley Hospice should have covered under the Medicare hospice benefit, the HHS Office of Inspector General says in a newly issued report (A-06-06-00102).

Reavis Super Drug billed the Oklahoma Health Care Authority for the drugs, but OHCA shouldn't have paid because the drugs were related to the hospice patients' terminal illnesses, according to the report conducted in conjunction with the OHCA Audit Services Division. The report looked at 60 drug claims for four beneficiaries in 2003.

The report is available online at http://oig.hhs.gov/oas/reports/region6/60600102.pdf.

• Community pharmacists trying to make sense of Medicare's coming competitive bidding program can tap a new resource.

The National Community Pharmacists Association has launched a Web site to provide information on accreditation and competitive bidding, as well as the forms and documentation needed to begin the accreditation process.

• Attention to Medicare managed care payments may help home care providers get out of the hot seat for the 2008 budget. Democrats want to cut Medicare Advantage payment rates to finance other spending priorities such as fixing a scheduled 10 percent reduction in Medicare physician payments, Congressional Quarterly reports. House Energy and Commerce Health Subcommittee Chair Frank Pallone (D-NJ), House Ways and Means Health Sub-committee Chair Pete Stark (D-CA) and Medicare Payment Advisory Commission Chair Glenn Hackbarth are endorsing the idea.

• Two congressman targeted home medical equipment fraud at a March 8 hearing before the U.S. House Ways and Means subcommittees on health and oversight.

Rep. Bill Pascrell, Jr. (D-NJ) asked why Medicare requires DME companies to have only a provider number and a physical address to bill Medicare. Rep. Patrick Tiberi (R-OH) called for more investigation regarding the ability of fraudulent providers to receive provider numbers.

CMS is working toward implementing a surety bond requirement, reported Tim Hill, CMS' chief financial officer. Mandatory accreditation will also help root out fraud, said Hill.

• Hospices wanting to add services of value to patients may want to follow the example of Dublin, CA-based Hope Hospice. The hospice signed an agreement with the local Valley Humane Society to help animals stay with their hospice-patient owners as long as possible, according to the Contra Costa Times.

Valley Humane will counsel and guide hospice employees, volunteers and patients on how to care for patients' pets; will take the pet into its adoption program if an alternative home isn't found; and will provide volunteers to visit patients' homes to care for the pet if needed, the newspaper reports.

"We want the person to know when they are cognizant that Valley Humane will take their animal into [its] care, assure them their pet will be placed in a loving home for life," Valley Humane's David Stegman told the Times. "They will have a clear conscience that their animal will be taken care of."