Home Health & Hospice Week

DMERCs receive worst grade in satisfaction survery.

If your regional home health intermediary is Palmetto GBA, you are among the group of home health agencies most satisfied with its Medicare contractor.

HHAs gave all four RHHIs an average ranking of 4.77 on a 1-6 scale, or 75 percent, according a new report detailing the findings of the latest Medicare Contractor Provider Satisfaction Survey conducted by the Centers for Medicare & Medicaid Services.

Palmetto ranked highest with a 4.88 satisfaction score, according to the survey that saw a 65 percent response rate. The lowest score was 4.65 for Associated Hospital Service.

"The RHHIs tend to score high and all have scores above the national average of 4.56," notes the report prepared by Rockville, MD-based Westat.

Durable medical equipment suppliers, however, were less happy with the services they receive from DME contractors. "DME Contractors tend to have low scores and all four have scores below the national average," the report points out. The average DME contractor score was 4.34.

The highest-scoring was Jurisdiction B, served by National Government Services, at 4.50 or 75 percent. The lowest-scoring DME contractor was Jurisdic-tion A with 4.20 (64 percent), followed closely by Jur-isdiction D with 4.21. Those areas were served by multiple contractors during those periods, the report notes.

Hospices were the most satisfied with their FI and RHHI contractors, giving them an average 4.81 (76 percent) rating. The report is online at www.cms.hhs.gov/MCPSS/downloads/MCPSS_Report.pdf.

• Be prepared for civil monetary penalties if you are a DME supplier who offers free oximetry testing for patients with congestive heart failure.

The HHS Office of Inspector General says no to two oxygen suppliers who proposed providing patients diagnosed with CHF with an in-home CHF assessment with oximetry testing, free of charge, according to a July 23 advisory opinion (No. 07-08).

The OIG cites kickback concerns as the reason for not approving the suppliers' plan. "Arrangements whereby a prospective provider or supplier of federally payable items and services offers beneficiaries a non-covered item or service free of charge implicate the fraud and abuse laws and must be closely scrutinized," the OIG says in its opinion.

To see the opinion, go online to http://oig.hhs.gov/w-new.html.

• You'd better make sure you're keeping up with the pack on three Home Health Compare measures that showed improvement in the latest quarter. If you don't,  you could be sorry once pay for performance hits.

Patients who get better at bathing improved from 63 to 64 percent. This outcome measure stood at 57 percent when Home Health Compare debuted in November 2003.

Patients who get better at taking oral medications rose from 41 to 42 percent over the three-month period, after starting at 35 percent in 2003.

And patients who are short of breath less often went from 60 to 61 percent. The measure was at 58 percent when it was first included in September 2005.

For more on OASIS-based outcome measures, see Eli's OASIS Alert at www.elihealthcare.com/spec_oasis.htm or by calling 1-800-874-9180.

• Medicare contractors may be turning up the heat on your claims soon. The HHS Office of Inspector General complains that the Program Safeguard Contractors (PSCs) aren't turning the screws hard enough on Medicare providers.

Some PSCs produced 80 or fewer new investigations of Part B providers in 2005, compared to 3,707 Part B investigations from the most active PSC, the OIG says in a report on the fraud-fighting contractors.

For Part A, the most aggressive PSC produced 479 new investigations while some contractors produced only five for the year, the report notes.

Also, many PSCs didn't seem to be generating new cases by analyzing your claims data and looking for problem trends, the OIG frets.

The OIG wants Medicare to look into the low-performing PSCs and see what more they could be doing to put the bite on fraud and abuse. If necessary, CMS may have to kick some PSCs to the curb, the OIG advises. The report is at www.oig.hhs.gov/oei/reports/oei-03-06-00010.pdf.

• If your hospice bills for physician services, you have a little more money coming to you. The claims processing system is paying such claims for 2007 services at 2006 payment rates, RHHI Cahaba GBA explains in a post to its Web site.

"After the problem is corrected, mass adjustments will be done to those claims which processed incorrectly," the intermediary assures providers.

• President Bush's nominee for CMS Administrator, Kerry Weems, got only a "light grilling" in his confirmation hearing before the Senate July 25, reports The Hill. Legislators pressed Weems on whether he would be stifled by the Bush administration.

"I have on many, many occasions resisted political pressure," the career bureaucrat who's never held a political appointment told the Senators, according to the newspaper.

Weems promised to step up agency oversight of providers if confirmed. That could mean further enforcement crackdowns, especially for durable medical equipment suppliers, experts predict.

• Another reason to get NPI-compliant: You won't be allowed to enroll in Electronic Data Interchange (EDI) unless you can obtain at least at least one National Provider Identifier, CMS says in Transmittal No. 1283 (C.R. 5637).

• Amedisys Inc. has another quarter of record-breaking earnings to crow about.

The Baton Rouge, LA-based regional chain reported net income of $14.9 million for the quarter ended June 30, up a whopping 65 percent from a $9.1 million profit in the same quarter of 2006. The company's service revenues grew 28 percent from $132.9 million to $169.5 million during the same time period.

• Pediatric Services of America Inc. stockholders will meet next month in Atlanta to vote on a proposed merger between PSA and investment firm Portfolio Logic, PSA says in a release. The deal will take the Norcross, GA-based company private.

• LHC Group Inc. didn't meet its earning targets this quarter because it had to take a charge on its long-term care acute hospital business line, the La-fayette, LA-based regional chain says in a release.

LHC reported earnings gains despite the $1.3 million charge. The company had $5.0 million in net income on $70.6 million in revenues for the quarter ended  June 30, compared to a $4.3 million profit on $50.0 million in revenues for the same time period in the previous year. Net service revenue for its home care business line was $58.0 million in the latest quarter.